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Copyright of Journal of Modern Medicine & Health is the property of Journal of Modern Medicine & Health and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Progress in Modern Biomedicine is the property of Publishing House of Progress in Modern Biomedicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Pectus excavatum (PE) is a common congenital chest wall deformity with various associated health concerns, including psychosocial impacts, academic challenges, and potential cardiopulmonary effects. Objective: This study aimed to investigate the cardiac consequences of right atrioventricular groove compression in PE using cardiac magnetic resonance imaging. Materials and methods: A retrospective analysis was conducted on 661 patients with PE referred for evaluation. Patients were categorized into three groups based on the degree of right atrioventricular groove compression (no compression (NC), partial compression (PC), and complete compression(CC)). Chest wall indices were measured: pectus index (PI), depression index (DI), correction index (CI), and sternal torsion. Results: The study revealed significant differences in chest wall indices between the groups: PE, NC=4.15 ± 0.94, PC=4.93 ± 1.24, and CC=7.2 ± 4.01 (P<0.0001). Left ventricle ejection fraction (LVEF) showed no significant differences: LVEF, NC=58.72% ± 3.94, PC=58.49% ± 4.02, and CC=57.95% ± 3.92 (P=0.0984). Right ventricular ejection fraction (RVEF) demonstrated significant differences: RVEF, NC=55.2% ± 5.3, PC=53.8% ± 4.4, and CC=53.1% ± 4.8 (P≥0.0001). Notably, the tricuspid valve (TV) measurement on the four-chamber view decreased in patients with greater compression: NC=29.52 ± 4.6; PC=28.26 ± 4.8; and CC=24.74 ± 5.73 (P<0.0001). Conclusion: This study provides valuable insights into the cardiac consequences of right atrioventricular groove compression in PE and lends further evidence of mild cardiac changes due to PE. [ABSTRACT FROM AUTHOR]

Background: This meta-analysis aimed to evaluate the impact of aerobic exercise on Peak VO2 (Oxygen Consumption) in postoperative patients with congenital heart disease (CHD). Besides this, we also tried to discover whether the improvement was influenced by patient ages, modes of supervision, types of exercise, the total dose of exercise, intervention periods, and types of CHD. Methods: Following the Population Intervention Comparison Outcome Study Design (PICOS) principle, a comprehensive search of the PubMed, Web of Science, Embase and Cochrane Library databases was conducted for randomized controlled trials (RCTs) evaluating the intervention effects of aerobic exercise on cardiopulmonary function in postoperative CHD patients until December 2023. This meta-analysis and publication bias tests were conducted using Stata 17.0, and the mean differences (MDs) with 95% confidence intervals (CIs) were used as effect sizes in statistics. Results: A total of 15 RCTs (762 cases) were included in this meta-analysis, with 407 cases in the experimental group and 355 cases in the control group. Meta-analysis showed that aerobic exercise had a positive effect on Peak VO2 in postoperative CHD patients (MD = 2.14, 95% CI (1.34, 2.94), p < 0.00001, I² = 36%). The analysis of subgroups showed that intervention effects of aerobic exercise were superior to the control group when patients were >18 years old (MD = 2.53, p < 0.00001), ≤18 years old (MD = 1.63, p = 0.01), under supervision (MD = 2.23, p < 0.00001), unsupervised (MD = 2.06, p < 0.00400), performing aerobic exercise (MD = 1.87, p = 0.0003), performing aerobic exercise combined with resistance training (MD = 2.57, p < 0.00010), with a total dose of exercise ≥1440 minutes (MD = 2.45, p < 0.00010), with the intervention period of 10–12 weeks (MD = 2.31, p < 0.00001), with that >12 weeks (MD = 1.97, p = 0.00300), or with mixed types of CHD (MD = 2.34, p < 0.00001). Conclusions: This meta-analysis did not deduct points for limitations, inconsistency, indirectness, imprecision, or publication bias, so the quality of evidence was graded as high. Aerobic exercise has a significantly positive impact on improving Peak VO2 in postoperative CHD patients. Moreover, it was found that for patients aged 18 and above, supervised aerobic exercise combined with resistance training, implemented for 10–12 weeks with a total dose of exercise ≥1440 minutes, had a better intervention effect on Peak VO2. This finding provided evidence-based medicine for the exercise rehabilitation of postoperative CHD patients, and explored the optimal exercise prescription for clinical practice as well. [ABSTRACT FROM AUTHOR]

Copyright of Guangdong Medical Journal is the property of Guangdong Medical Journal Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Remote ischemic preconditioning (RIPC) is reported to have early‐phase and delayed‐phase organ‐protective effects. Previous studies have focused on the organ protection of a single RIPC protocol, and the clinical outcomes remain uncertain. Whether the modified RIPC (mRIPC) protocol performed repeatedly provides cardiopulmonary protection is still uncertain. Methods: In this single‐center, randomized, controlled trial, 86 patients undergoing elective mitral valve replacement (MVR) surgery were randomized 1:1 to receive either mRIPC or no ischemic preconditioning (control). Three cycles of 5 min ischemia and 5 min reperfusion induced by a blood pressure cuff served as the RIPC stimulus. mRIPC was induced at the following three time points: 24 h, 12 h, and 1 h before surgery. Blood samples were withdrawn at 10 min after intubation (T0), at 1 h after aortic declamping (T1), and at 6 h (T2), 12 h (T3), and 24 h (T4) after surgery to measure the serum concentrations of myocardial enzymes and other biomarkers, including cardiac troponin I (cTnI), which was the primary endpoint of this study. Creatine kinase isoenzyme (CK‐MB), lactate dehydrogenase (LDH), inotropic score (IS), and inflammatory mediators were also measured. Blood gas analysis was conducted to calculate the PaO2/FiO2 ratio and A‐aDO2, and the incidence of acute lung injury (ALI) was also recorded. Results: mRIPC significantly decreased the serum concentrations of cTnI, CK‐MB, and LDH at T2, T3, and T4 (p < 0.01), and the IS decreased compared with that in the control group (12.0 ± 1.0 vs. 14.2 ± 1.1, p < 0.01). In addition, the incidence of ALI in the mRIPC group was decreased (32.6% vs. 51.2%, p = 0.039), and the PaO2/FiO2 was higher at T4 (p < 0.05). Compared with those in the control group, the levels of interleukin‐6 (IL‐6) and tumor necrosis factor‐α (TNF‐α) were decreased at T1, T2, T3, and T4 (p < 0.05) in the mRIPC group, and the level of IL‐10 increased at the same time. Conclusions: mRIPC decreased the incidence of myocardial and lung injury in MVR surgery, providing new evidence for the clinical application of RIPC in valve surgery. Trial Registration: ClinicalTrials.gov (NCT01406678). [ABSTRACT FROM AUTHOR]

This study investigates whether exercise as a strategy for improving physical fitness at sea level also offers comparable benefits in the unique context of high altitudes (HA), considering the physiological challenges of hypoxic conditions. Overall, 121 lowlanders who had lived on the Tibetan Plateau for >2 years and were still living at HA during the measurements were randomly classified into four groups. Each individual of the low‐intensity (LI), moderate‐intensity (MI), and high‐intensity (HI) groups performed 20 sessions of aerobic exercise at HA (3680 m) over 4 weeks, while the control group (CG) did not undergo any intervention. Physiological responses before and after the intervention were observed. The LI and MI groups experienced significant improvement in cardiopulmonary fitness (0.27 and 0.35 L/min increases in peak oxygen uptake [V˙ $\dot{\mathrm{V}}$O2peak], both p < 0.05) after exercise intervention, while the hematocrit (HCT) remained unchanged (p > 0.05). However, HI exercise was less efficient for cardiopulmonary fitness of lowlanders (0.02 L/min decrease in V˙ $\dot{\mathrm{V}}$O2peak, p > 0.05), whereas both the HCT (1.74 %, p < 0.001) and glomerular filtration rate (18.41 mL/min, p < 0.001) increased with HI intervention. Therefore, LI and MI aerobic exercise, rather than HI, can help lowlanders in Tibet become more acclimated to the HA by increasing cardiopulmonary function and counteracting erythrocytosis. Highlights: Low‐ and moderate‐intensity exercise at HA can improve oxygen transport of lowlanders that may help them to become more acclimated to high altitude.High‐intensity exercise performed by lowlanders may result in erythrocytosis without improving oxygen transport.The relationship between physiological system changes induced by exercise performed at HA is modulated by exercise intensity. [ABSTRACT FROM AUTHOR]

Summary: In a prospective, randomized, controlled crossover study, we explored the effects of acute intermittent hypoxia and acute continuous hypoxia on patients with mild–moderate obstructive sleep apnea. Over three single‐night sessions, subjects were alternately exposed to normoxia, acute continuous hypoxia and acute intermittent hypoxia before sleep. The apnea–hypopnea index and oxygen desaturation index were used to diagnose obstructive sleep apnea and evaluate efficacy. A responder was defined as a participant with a ≥ 50% reduction in apnea–hypopnea index between normoxia and hypoxia exposure. Sixteen participants with mild–moderate obstructive sleep apnea completed the study. Compared with normoxia, the mean apnea–hypopnea index decreased by 8.9 events per hr (95% confidence interval, 4.2–13.6, p = 0.001) with acute intermittent hypoxia and by 4.1 events per hr (95% confidence interval, 0.5–8.8, p = 0.082) with acute continuous hypoxia, equating to a mean decrease in apnea–hypopnea index of 4.8 events per hr (95% confidence interval, 0.1–9.5, p = 0.046) with acute intermittent hypoxia compared with acute continuous hypoxia. Compared with normoxia, the mean oxygen desaturation index decreased by 9.8 events per hr (95% confidence interval, 4.4–15.1, p = 0.001) with acute intermittent hypoxia but did not significantly decrease with acute continuous hypoxia; the mean oxygen desaturation index decreased by 7.2 events per hr (95% confidence interval, 1.8–12.6, p = 0.010) with acute intermittent hypoxia compared with acute continuous hypoxia. Of the 16 participants, 11 responded to acute intermittent hypoxia and four responded to acute continuous hypoxia (p = 0.032), of whom eight of 11 cases and all four cases had oxygen desaturation indexes <5 events per hr, respectively (p = 0.273). All participants tolerated acute intermittent hypoxia and there were no obvious adverse events during acute intermittent hypoxia exposure. In conclusion, acute intermittent hypoxia exposure improved apnea–hypopnea index and oxygen desaturation index in patients with mild–moderate obstructive sleep apnea, suggesting that further prospective validation of intermittent hypoxia exposure in patients with obstructive sleep apnea is needed to establish its clinical feasibility as a therapeutic modality. [ABSTRACT FROM AUTHOR]

High intensity interval training (HIIT) is now a very exercise attention by society, scholars from all over the world have to look into the training methods. At present, most studies on HIIT in the market compare it with moderate intensity continuous aerobic exercise. From another perspective, this study compares HIIT training with typical Repetition Training (RT) in strength training to study the changes of cardiopulmonary function indicators in adolescents. The aim is to find a more suitable and efficient way for youth sports training, so as to improve their physical fitness level. [ABSTRACT FROM AUTHOR]

Purpose: This study explored the use of transthoracic lung ultrasound for evaluating COVID‐19 patients, compared it with computed tomography (CT), and examined its effectiveness using 8 and 12 lung regions. Methods: A total of 100 patients with COVID‐19 and 40 healthy volunteers were assessed using 12 regions (bilateral upper/lower regions of the anterior/lateral/posterior chest) and simplified 8 zones (bilateral upper/lower regions of the anterior/lateral chest) transthoracic lung ultrasound. The relationships between ultrasound, CT, and clinical indicators were analyzed to evaluate the diagnostic value of ultrasound scores in COVID‐19. Results: Increased disease severity correlated with increased 8‐ and 12‐zone ultrasound and CT scores (all p < 0.05). The modified 8‐zone method strongly correlated with the 12‐zone method (Pearson's r = 0.908, p < 0.05). The 8‐ and 12‐zone methods correlated with CT scoring (correlation = 0.568 and 0.635, respectively; p < 0.05). The intragroup correlation coefficients of the 8‐zone, 12‐zone, and CT scoring methods were highly consistent (intragroup correlation coefficient = 0.718, p < 0.01). The 8‐zone ultrasound score correlated negatively with oxygen saturation (rs = 0.306, p < 0.05) and Ca (rs = 0.224, p < 0.05) and positively with IL‐6 (rs = 0.0.335, p < 0.05), erythrocyte sedimentation rate (rs = 0.327, p < 0.05), alanine aminotransferase (rs = 0.230, p < 0.05), and aspartate aminotransferase (rs = 0.251, p < 0.05). The 12‐zone scoring method correlated negatively with oxygen saturation (rs = 0.338, p < 0.05) and Ca (rs = 0.245, p < 0.05) and positively with IL‐6 (rs = 0.354, p < 0.05) and erythrocyte sedimentation rate (rs = 0.495, p < 0.05). Conclusion: Lung ultrasound scores represent the clinical severity and have high clinical value for diagnosing COVID‐19 pneumonia. The 8‐zone scoring method can improve examination efficiency and reduce secondary injuries caused by patient movement. [ABSTRACT FROM AUTHOR]

Copyright of Herz is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Although some studies have shown that exercise has a good effect on improving the cardiopulmonary function of stroke patients, it still needs to be determined which exercise method does this more effectively. We, therefore, aimed to evaluate the effectiveness of different exercise methods in improving cardiovascular function in stroke patients through a network meta-analysis (NMA), providing a basis to select the best treatment plan for stroke patients. Methods: We systematically searched CNKI, WanFang, VIP, CBM, PubMed, Embase, Web of Science, and The Cochrane Library databases from establishment to 30 April 2023. Randomized controlled trials (RCTS) on exercise improving cardiopulmonary function in stroke patients were included, and we screened the included articles and extracted the relevant data. RevMan (version 5.4) and Stata (version 17.0) were used for data analysis. Results: We included 35 RCTs and a total of 2,008 subjects. Intervention measures included high-intensity interval training (HIIT), aerobic training (AT), resistance training (RT), combined aerobic and resistance exercise (CE), and conventional therapy (CT). In the network meta-analysis, the surface under the cumulative ranking area (SUCRA) ranking result indicated that HIIT improved peak oxygen uptake (VO2peak) and 6 mins walking distance (6MWD) optimally, with rankings of HIIT (100.0%) > CE (70.5%) > AT (50.2%) > RT (27.7%) > CT (1.6%), and HIIT (90.9%) > RT (60.6%) > AT (48.9%) > RT (48.1%) > CT (1.5%), respectively. The SUCRA ranking result showed that CE improved systolic blood pressure (SBP) and diastolic blood pressure (DBP) optimally, with rankings of CE (82.1%) > HIIT (49.8%) > AT (35.3%) > CT (32.8%), and CE (86.7%) > AT (45.0%) > HIIT (39.5%) > CT (28.8%), respectively. Conclusion: We showed that exercise can effectively improve the cardiopulmonary function of stroke patients. HIIT was the most effective in improving VO2peak and 6MWD in stroke patients. CE was the most effective in improving SBP and DBP in stroke patients. However, due to the limitations of existing clinical studies and evidence, larger sample size, multi-center, and high-quality RCTs are needed to verify the above conclusions in the future. [ABSTRACT FROM AUTHOR]

Purpose: College students are the future of a nation; education community needs to prioritize students' health issues. Method: This article compares the measurement data of cardiovascular function, bone density, body composition, and physical fitness between female college students in the exercise group and the control group before and after 12 weeks, in order to explore the impact of basketball on human morphology and physiological function. This can provide more methods and scientific basis for students to enhance their physical fitness and promote physical health. Results: The exercise group's lung capacity after the experiment was 2517ml, and the control group's lung capacity after the experiment was 2357ml. Conclusion: This article has important practical significance in promoting the improvement of college students' physical fitness, and can also provide reference for ordinary higher education institutions to offer various sports courses. [ABSTRACT FROM AUTHOR]

Patients with chronic kidney disease (CKD) have an exacerbated prevalence of cardiovascular disease (CVD). Vascular dysfunction, characterized by impaired endothelial function and arterial stiffness, and markedly low cardiorespiratory fitness levels are hallmark manifestations of the disease that contribute to the CVD burden. Despite advancements in blood pressure and lipid lowering pharmacological therapies, CVD remains markedly prevalent across the spectrum of CKD. This highlights a stagnation in effective clinical strategies to improve cardiovascular health and reinforces the critical need for adjuvant lifestyle strategies such as physical activity and exercise training to be incorporated into routine clinical care. This narrative review provides an overview of the known effects of exercise on vascular and cardiopulmonary function across the spectrum of CKD. The physiological mechanisms of vascular dysfunction that serve as exercise-specific therapeutic targets are highlighted and future perspectives are discussed. [ABSTRACT FROM AUTHOR]

Background and Objective: This study aimed to evaluate the longitudinal changes in cardiopulmonary function (CPF) and identify predictors of cardiopulmonary recovery failure after lung cancer surgery. Methods: Data was obtained from a prospective CATCH‐LUNG cohort study, where patients were divided into two groups based on 6‐min walk distance (6MWD) at baseline and 6 months after surgery. CPF recovery failure was defined as a participant whose 6MWD dropped over 50 m from baseline to 6 months after surgery. Patients with a baseline 6MWD less than 400 m were excluded. The analysis was investigated using mixed effects models, and the relative estimates for the predictors were expressed relative risk (RR) and 95% CI using a Poisson regression. Results: Among 419 patients, 24.1% and 17.7% showed failure of CPF recovery at 6 months and 1 year after surgery, respectively. In the multivariable analysis, baseline step count [RR per 1000 steps lower = 1.05 (95% CI, 1.01–1.09)], baseline dyspnoea [RR per 10 points higher = 1.15(1.07–1.23)], decreased FEV1% predicted from baseline to 2 weeks after surgery [RR per 10% lower = 1.30(1.10–1.53)] and decreased moderate‐to‐vigorous physical activity (MVPA) from baseline to 2 weeks [RR = 1.95(1.22, 3.11)] or persistent low MVPA at baseline and 2 weeks after surgery [RR = 1.63(1.04, 2.54)] were significant factors for loss of CPF. Conclusion: The inability to recover CPF at 6 months after surgery was linked to reduction of lung function and MVPA from baseline to 2 weeks as well as baseline physical activity (PA) and dyspnoea. These results imply that engagement of perioperative PA is necessary to facilitate recovery of CPF after lung cancer surgery. [ABSTRACT FROM AUTHOR]

This study aimed to analyze the correlation between the rate pressure product (RPP) and cardiopulmonary function during hospitalization in patients with acute myocardial infarction (AMI). A total of 362 patients with AMI were selected for the study, and the median admission RPP was used as the cutoff point to divide the patients into a low-RPP group (n = 181) and a high-RPP group (n = 181). The relationship between the RPP at admission and the cardiopulmonary function during hospitalization was analyzed. The patients in the high-RPP group had a higher body mass index (BMI) (p = 0.014), a higher prevalence of combined hypertension and diabetes mellitus (p < 0.001), a lower incidence of smoking (p = 0.044), and a higher incidence of oscillatory ventilation (6.1% vs. 1.7%, p = 0.029). The differences in RPP at rest, during warm-up, and within 1 and 4 minutes of recovery were statistically significant between the two groups (p < 0.01 on each occasion), while the differences in anaerobic threshold (AT) and watt max (Max) were not statistically significant (p > 0.05 for both). The patients in the low-RPP group had higher oxygen uptake (VO2 [AT]: 14.9 ± 3.4 vs. 14.2 ± 3.6, p = 0.048) and (VO2peak [Max]:18.2 ± 3.8 vs. 17.3 ± 3.8, p = 0.020). The RPP at admission was negatively correlated with VO2 (AT) and VO2peak (p < 0.05) using the regression Equation VO2peak = 33.682 + (−0.012 * RPP at admission/100) + (−0.105 * Age) + (−0.350 * BMI), while there was no correlation between the RPP at admission and VO2 (AT) (p = 0.149). The RPP at admission was negatively correlated with cardiopulmonary function during hospitalization in patients with AMI. Patients with a high RPP were more likely to have a combination of obesity, hypertension, diabetes mellitus, and reduced oxygen uptake during exercise, while a high RPP at admission appeared to affect their cardiovascular response indicators during exercise. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Arteriosclerosis is the property of Chinese Journal of Arteriosclerosis Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Requirements of blood transfusions rise rapidly in China. Improving the efficiency of blood donation could help maintaining sufficient blood supplement. We conducted a pilot research to investigate the reliability and safety of collecting more units of red blood cell by apheresis. Methods: Thirty‐two healthy male volunteers were randomized into two groups: red blood cell apheresis (RA) (n = 16) and whole blood (WB) donation (n = 16). RA group donated individualized RBC volumes by apheresis according to the volunteers' basal total blood volumes and haematocrit levels, WB group donated 400 mL whole blood. All volunteers were scheduled seven visit times in 8 weeks' study period. The cardiovascular functions were assessed by laboratory examinations, echocardiography and cardiopulmonary functional tests. All results were compared between groups at the same visit time and compared between visit 1(before donation) and other visit times within the same group. Results: The average donated RBC volume in RA group and in WB group was 627.25 ± 109.74 mL and 175.28 ± 8.85 mL, respectively(p < 0.05); the RBC, haemoglobin and haematocrit levels changed significantly between times and between groups (p < 0.05). Cardiac biomarker levels such as NT‐proBNP, hs‐TnT and CK‐MB did not change significantly between times or between groups (p > 0.05). The echocardiographic and cardiopulmonary results did not change significantly between times or between groups during the whole study period(p > 0.05). Conclusions: We provided an efficient and secure method for RBC apheresis. By harvesting more RBC volumes at one single‐time, the cardiovascular functions did not change significantly compared with traditional whole blood donation. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Valvular heart disease (VHD) is a type of cardiovascular disease with abnormal heart valve structure and/or function and a rapidly growing cause of global cardiovascular morbidity and mortality. Physical inactivity is a problem for patients with VHD, especially after surgery. However, there is no data on the effects of exercise on VHD from large multicentre randomised controlled trials (RCTs). Therefore, we conducted a systematic review and meta-analysis to provide a comprehensive analysis of small RCTs to evaluate the effects of exercise on cardiopulmonary function in patients with VHD and provide an evidence-based medicine basis for developing and guiding the clinical application of exercise in patients with VHD. Methods: We conducted a systematic review and meta-analysis of RCTs. We systematically searched electronic databases (PubMed, Web of Science, Embase, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure [CNKI], China Science and Technology Journal Database [VIP], WanFang Database, and SinoMed [CBM]) for all studies on exercise and VHD from their inception to January 2023. The quality of included studies was assessed using the Cochrane risk-of-bias tool. The primary outcomes were the six-minute walk test distance (6MWD), left ventricular ejection fraction (LVEF), and short-form 36-item health survey (SF-36). Results: This systematic review included 22 RCTs with 1520 subjects (869 men and 651 women). The meta-analysis results showed that exercise significantly improved exercise capacity measured by the 6MWD (mean difference [MD] = 25.54, 95% confidence interval [CI] = 19.98–31.11, I 2 = 0%, p < 0.00001), LVEF (MD = 6.20, 95% CI = 4.76–7.65, I ² = 66%, p < 0.00001), and quality of life measured by the SF-36 (physical function: MD = 3.42, 95% CI = 2.12– 4.72, I ² = 12%, p < 0.00001; mental health: MD = 3.86, 95% CI = 0.52–7.20, I ² = 68%, p = 0.020; social function: MD = 2.30, 95% CI = 0.64–3.97, I ² = 45%, p = 0.007; bodily pain: MD = 2.60, 95% CI = 0.83–4.37, I ² = 22%, p = 0.004) in patients with VHD compared to healthy controls. Conclusions: This study suggests that exercise can significantly improve cardiopulmonary function, enhance physical and social function, reduce bodily pain, and potentially improve mental health in patients with VHD, providing an evidence-based basis for better recovery in patients with VHD. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Type 2 diabetes mellitus (T2DM) represents a major health issue worldwide, as patients with T2DM show an excess risk of death for cardiovascular causes, twice as high as the general population. Among the many complications of T2DM, heart failure (HF) deserves special consideration as one of the leading causes of morbidity and reduced life expectancy. T2DM has been associated with different phenotypes of HF, including HF with reduced and preserved ejection fraction. Cardiopulmonary exercise testing (CPET) can evaluate the metabolic and ventilatory alterations related to myocardial dysfunction and/or peripheral impairment, representing a unique tool for the clinician to study the whole HF spectrum. While CPET allows for a thorough evaluation of functional capacity, it cannot directly differentiate central and peripheral determinants of effort intolerance. Combining CPET with imaging techniques could provide even higher accuracy and further insights into the progression of the disease since signs of left ventricular systolic and diastolic dysfunction can be detected during exercise, even in asymptomatic diabetic individuals. This review aims to dissect the alterations in cardiopulmonary function characterising patients with T2DM and HF to improve patient risk stratification. [ABSTRACT FROM AUTHOR]

Copyright of Progress in Modern Biomedicine is the property of Publishing House of Progress in Modern Biomedicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Progress in Modern Biomedicine is the property of Publishing House of Progress in Modern Biomedicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Progress in Modern Biomedicine is the property of Publishing House of Progress in Modern Biomedicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Progress in Modern Biomedicine is the property of Publishing House of Progress in Modern Biomedicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

(1) Background: COVID-19 is often associated with significant long-term symptoms and disability, i.e., the long/post-COVID syndrome (PCS). Even after presumably mild COVID-19 infections, an increasing number of patients seek medical help for these long-term sequelae, which can affect various organ systems. The pathogenesis of PCS is not yet understood. Therapy has so far been limited to symptomatic treatment. The Greifswald Post COVID Rehabilitation Study (PoCoRe) aims to follow and deeply phenotype outpatients with PCS in the long term, taking a holistic and comprehensive approach to the analysis of their symptoms, signs and biomarkers. (2) Methods: Post-COVID outpatients are screened for symptoms in different organ systems with a standardized medical history, clinical examination, various questionnaires as well as physical and cardiopulmonary function tests. In addition, biomaterials are collected for the analysis of immunomodulators, cytokines, chemokines, proteome patterns as well as specific (auto)antibodies. Patients are treated according to their individual needs, adhering to the current standard of care. PoCoRe's overall aim is to optimize diagnostics and therapy in PCS patients. [ABSTRACT FROM AUTHOR]

Upper abdominal surgical treatment may reduce respiratory muscle function and mucociliary clearance, which might be a cause of postoperative pulmonary complications (PPCs). Threshold inspiratory muscle training (IMT) may serve as an effective modality to improve respiratory muscle strength and endurance in patients. However, whether this training could help patients with upper abdominal surgery remains to be determined. The aim of the present investigation was to determine the effect of a fully engaged IMT on PPCs and respiratory function in patients undergoing upper abdominal surgery. We hypothesized that the fully engaged IMT could reduce PPCs and improve respiratory muscle function in patients with upper abdominal surgery. This is a randomized controlled trial (RCT) with 28 patients who underwent upper abdominal surgery. Patients were randomly assigned to the control (CLT) group or the IMT group. The CTL group received regular health care. The IMT group received 3 weeks of IMT with 50% of MIP as the initial intensity before the operation. The intensity of MIP increased by 5–10% per week. The IMT was continued for 4 weeks after the operation. The study investigated the outcomes including PPCs, respiratory muscle strength, diaphragmatic function, cardiopulmonary function, and quality of life (QoL). We found that IMT improved respiratory muscle strength and diaphragmatic excursion. IMT also had a beneficial effect on the incidence of postoperative pulmonary complications (PPCs) compared to CLT care. The results from this study revealed that IMT provided positive effects on parameters associated with the respiratory muscle function and reduced the incidence of PPCs. We propose that fully engaged IMT should be a part of clinical management in patients with upper abdominal surgery. The fully engaged inspiratory muscle training reduces postoperative pulmonary complications rate in patients with upper abdominal surgery. The fully engaged inspiratory muscle training increases maximal inspiratory pressure in patients with upper abdominal surgery. The fully engaged inspiratory muscle training increases diaphragm function in patients with upper abdominal surgery. The fully engaged inspiratory muscle training increases the quality of life in patients with upper abdominal surgery. [ABSTRACT FROM AUTHOR]

Copyright of Progress in Modern Biomedicine is the property of Publishing House of Progress in Modern Biomedicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Shandong Medical Journal is the property of Shandong Medical Health Newspapers and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The purpose of this study was to examine what effects the coronavirus disease 2019 (COVID-19) pandemic has on the cardiopulmonary endurance, heart rate and oxygen saturation in children with cerebral palsy (CP) during a 6-min walk test (6 MWT). This study had a laboratory design and tested a single group pre- and post-COVID-19. A convenience sample of 8 participants with CP (three females; mean age ± SD = 1 3 ± 6. 4 years) that was recruited from a community-based rehabilitation center was enrolled in the current study. Due to COVID-19, no rehabilitation was provided by a physical therapist for two months as the participants stayed at home. The descriptive statistics and paired t -test were derived by examining the participants' cardiopulmonary function via the Borg scale, 6 MWT, heart rate and oxygen saturation, while they underwent rehabilitation versus the two months without rehabilitation due to COVID-19. The participants' walking distances, oxygen saturation and heart rates were measured, and the Borg scale was used to assess the participants' perceptions of their fatigue, breathlessness, and effort and exertion during the 6 MWT. The descriptive statistical analysis demonstrated the following effects when comparing the post-COVID-19 results to those before the pandemic: greater distance on the 6 MWT test (0.69%), minimal changes in oxygen saturation (− 0.3%) and increased heart rate (8.4%) and Borg scale values (19.4%). Paired t -test suggested that a significant difference was shown on the Borg scale (P = 0. 0 4) and heart rate (P = 0. 0 1). The results of this study provide clinical, evidence-based insights into the impact of the COVID-19 pandemic on cardiopulmonary function in children with CP. The clinical case series study demonstrated that after the COVID-19 pandemic, the participants with CP experienced increased heart rates and decreased minimal oxygen saturation, cardiopulmonary endurance. Recent advances in communication and information technology allow physical therapists to train and refine individually through remote rehabilitation. Exercise and combining VR remote education can be a way to maintain cardiopulmonary functions that have fallen due to the pandemic. [ABSTRACT FROM AUTHOR]

Breast cancer survivors (BCS) have a high prevalence of cardiovascular disease and low cardiorespiratory fitness (CRF). CRF is an important predictor of survival in BCS. However, the physiological factors that contribute to low CRF in BCS have not been completely elucidated. To assess differences in physiological factors (cardiac, pulmonary, muscle function) related to CRF between BCS and controls. Twenty-three BCS and 23 age-body mass index (BMI) matched controls underwent a peak cycling exercise test to determine CRF, with physiological factors measured at resting and at peak exercise. Cardiac hemodynamics (stroke volume [SV], SVindex, heart rate [HR], cardiac output [Formula: see text], and [Formula: see text]index) were evaluated using ultrasonography. Pulmonary function was evaluated using the oxygen uptake efficiency slope (OUES), ventilation to carbon dioxide production slope [Formula: see text] and breathing reserve at peak exercise (BR). Muscle oxygenation variables (oxygenated [HbO2] deoxygenated [HHb] and total hemoglobin [Hb], and tissue oxygenation index [TSI]) were measured with near-infrared spectroscopy (NIRS). Both groups had similar CRF and similarly increased all hemodynamic variables (HR, SV, SVindex, [Formula: see text] and [Formula: see text]index) at peak exercise compared to resting (p < 0.001). BCS had higher overall HR and lower SVindex (group effect, p < 0.05). BCS had similar OUES, [Formula: see text] and BR compared to the controls. Both groups decreased TSI, and increased Hb and HHb similarly at peak exercise compared to resting (p < 0.001). Our data suggest BCS do not exhibit differences in cardiac, pulmonary, or muscle function at peak exercise compared to controls, when both groups have similar CRF and physical activity. [ABSTRACT FROM AUTHOR]

The prevalence of acute coronary syndrome in Korea has steadily increased, however, the understanding of and participation rate in cardiac rehabilitation (CR) is very low. There are few studies have been conducted in myocardial infarction (MI) patients with reduced heart function, a so-called high-risk group. Therefore, it is necessary to compare the effects of CR on the degree of improvement in cardiopulmonary fitness (CPF), whether MI patients participate or not, especially in the patients that are at a high risk of MI. Three hundred and ninety-four patients that were commissioned for CR between January 2016 and December 2020 were screened for risk stratification based on the American Association of Cardiovascular and Pulmonary Rehabilitation guidelines, and 115 were classified as high-risk patients. We retrospectively reviewed the patients who underwent both an exercise tolerance test (ETT) during the initial visit and 3 months after the onset of the study. During this period, 42 subjects were included, of which, 26 underwent at least one CR session and 16 did not. The baseline characteristics of the patients showed no significant differences. The results of the CPF improvement were measured as peak oxygen consumption (VO2 peak) and metabolic equivalent of tasks (METs) values which were derived through the ETT. Prior to the ETT, all of the demographic features, including ejection fraction, showed that there were no significant differences between the two groups. The initial CPF values were the same. However, after three months, the VO2 peak and METs values showed that there were significant differences between the two groups (p < 0.01). Additionally, the exercise time differed significantly between the two groups. The CPF values and exercise time showed a significant increase after 3 months in the CR participants. Therefore, it is necessary to initiate cardiac rehabilitation especially in high-risk patients as soon as the patient's vital signs are stable to improve their cardiopulmonary function. [ABSTRACT FROM AUTHOR]

Introduction: Pulmonary embolism is a common cause of cardiopulmonary mortality and morbidity worldwide. Survivors of acute pulmonary embolism may experience dyspnea, report reduced exercise capacity, or develop overt pulmonary hypertension. Clinicians must be alert for these phenomena and appreciate the modalities and investigations available for evaluation.Areas Covered: In this review, the current understanding of available contemporary imaging and physiologic modalities is discussed, based on available literature and professional society guidelines. The purpose of the review is to provide clinicians with an overview of these modalities, their strengths and disadvantages, and how and when these investigations can support the clinical work-up of patients post-pulmonary embolism.Expert Opinion: Echocardiography is a first test in symptomatic patients post-pulmonary embolism, with ventilation/perfusion scanning vital to determination of whether there is chronic residual emboli. The role of computed tomography and magnetic resonance in assessing the pulmonary arterial tree in post-pulmonary embolism patients is evolving. Functional testing, in particular cardiopulmonary exercise testing, is emerging as an important modality to quantify and determine cause of functional limitation. It is possible that future investigations of the post-pulmonary embolism recovery period will better inform treatment decisions for acute pulmonary embolism patients. [ABSTRACT FROM AUTHOR]

Background: Decreased cardiorespiratory fitness (CRF) related to cardiopulmonary function increases the risk of cardiovascular disease in patients with end‐stage kidney disease. Thus, early detection of the cause of impaired cardiopulmonary function in patients undergoing peritoneal dialysis (PD) is of important clinical significance. Methods: In this cross‐sectional study, symptom‐restricted cardiopulmonary exercise testing (CPET) was performed in 30 patients undergoing PD and in 23 age‐ and sex‐matched healthy control subjects. A fixed workload was added every minute until fatigue, and breath‐by‐breath respiratory gas was analysed with an automated gas analyzer at 10‐s intervals. Results: The peak oxygen uptake (16.39 ± 0.83 vs. 25.77 ± 1.33 ml/kg/min p < 0.001) and the oxygen uptake at the anerobic threshold of patients undergoing PD (9.61 ± 0.34 vs. 14.55 ± 0.64 ml/kg/min; p < 0.001) were lower than in healthy control subjects, and both of these parameters correlated with body mass index and left atrial dimension. A steeper minute ventilation/carbon dioxide production slope (27.20 ± 0.68 vs. 24.29 ± 0.69；p < 0.01) and a lower end‐tidal carbon dioxide partial pressure (37.93 ± 0.54 vs. 41.27 ± 0.83 mmHg；p < 0.05) were observed in patients undergoing PD. The oxygen pulse and oxygen uptake efficiency slope was smaller in patients undergoing PD. The Maximum heart rate (126.07 ± 4.01 vs. 149.96 ± 5.29 bpm；p < 0.01) and 1‐min heart rate recovery (13.93 ± 1.52 vs. 24.39 ± 1.61 bpm；p < 0.01) were also lower in patients undergoing PD. Conclusion: Subclinical cardiopulmonary dysfunction may exist in patients with PD, and a reduction in CRF in patients undergoing PD is affected by both central and peripheral functions. CPET has potential value in revealing the mechanism of impaired CRF and in discovering subclinical abnormalities in cardiopulmonary function. [ABSTRACT FROM AUTHOR]

Objective: This study was conducted on 27 senior adults in a community in Beijing with the purpose of examining the possible correlation between cardiorespiratory function and cognitive function. Methods: A questionnaire was designed for the basic demographic characteristics. The electronic blood pressure meter and electronic lung capacity meter were used to test cardiorespiratory function. The items of the cardiorespiratory function were scored in standard percentage. The MoCA Scale was used for cognitive function measurement. Results: The average heart rate (beats per minute) was 78.9 with a standard deviation of 13.5, and the average vital capacity (ml) was 1386.3 with a standard deviation of 37.0. In 15 people, the measured blood pressure was above the hypertension standard. The average cognitive function score was 22.5 with a standard deviation of 4.3. Eighteen people (66.7%) had mild cognitive impairments. Multiple linear regression analysis showed that there was no statistically significant correlation between cardiorespiratory function and cognitive function in the elderly (P > 0.05). Conclusion: No correlation was found between cardiopulmonary function and cognitive function in the elderly participating in this study and further large-scale population research is needed in the future. In this study, the prevalence of mild cognitive impairment was higher than in other studies. Attention should be paid to this issue, and early intervention should be done to avoid inactivity in senior adults. [ABSTRACT FROM AUTHOR]

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Objective: To explore the impacts of surgical mask in normal subjects on cardiopulmonary function and muscle performance under different motor load and gender differences. Design: Randomized crossover trial. Setting: The Fifth Affiliated Hospital of Guangzhou Medical University, June 16th to December 30th, 2020. Participants: Thirty-one college students (age: male 21.27 ± 1.22 years; female 21.31 ± 0.79 years) were recruited and randomly allocated in two groups. Interventions: Group 1 first received CPET in the mask-on condition followed by 48 h of washout, and then received CPET in the mask-off condition. Group 2 first received CPET in the mask-off condition followed by 48 h of washout, then received CPET in the mask-on condition. The sEMG data were simultaneously collected. Main outcome measures: The primary outcome was maximum oxygen uptake (VO2 max) from CPET, which was performed on a cycle ergometer—this is the most important parameter associated with an individual's physical conditioning. The secondary parameters included parameters reflecting exercise tolerance and heart function (oxygen uptake, anaerobic valve, maximum oxygen pulse, heart rate reserve), parameters reflecting ventilation function (respiration reserve, ventilation volume, tidal volume, breathing frequency), parameters reflecting gas exchange (end-tidal oxygen and carbon dioxide partial pressure, oxygen equivalent, carbon dioxide equivalent, and the relationship between dead space and tidal volume) and parameters reflecting skeletal muscle function [oxygen uptake, anaerobic valve, work efficiency, and EMG parameters including root mean square (RMS)]. Results: Comparing the mask-on and mask-off condition, wearing surgical mask had some negative effects on VO2/kg (peak) and ventilation (peak) in both male and female health subjects [VO2/kg (peak): 28.65 ± 3.53 vs 33.22 ± 4.31 (P = 0.001) and 22.54 ± 3.87 vs 26.61 ± 4.03 (P < 0.001) ml/min/kg in male and female respectively; ventilation (peak): 71.59 ± 16.83 vs 82.02 ± 17.01 (P = 0.015) and 42.46 ± 10.09 vs 53.95 ± 10.33 (P < 0.001) liter in male and female respectively], although, based on self-rated scales, there was no difference in subjective feelings when comparing the mask-off and mask-on condition. Wearing surgical masks showed greater lower limb muscle activity just in male subjects [mean RMS of vastus medialis (load): 65.36 ± 15.15 vs 76.46 ± 19.04 μV, P = 0.031]. Moreover, wearing surgical masks produced a greater decrease in △tidal volume (VTpeak) during intensive exercises phase in male subjects than in female [male − 0.80 ± 0.15 vs female − 0.62 ± 0.11 l P = 0.001]. Conclusions: Wearing medical/surgical mask showed a negative impact on the ventilation function in young healthy subjects during CPET, especially in high-intensity phase. Moreover, some negative effects were found both in ventilation and lower limb muscle actives in male young subjects during mask-on condition. Future studies should focus on the subjects with cardiopulmonary diseases to explore the effect of wearing mask. Trial registration: Chinese Clinical Trial Registry (ChiCTR2000033449). [ABSTRACT FROM AUTHOR]

Background: Cardiopulmonary exercise tests (CPETs) are widely used non-invasive and reliable functional evaluation methods. This study investigated the correlation between cardiopulmonary endurance indices and plasma glucose levels and abdominal visceral fat in males with new-onset type 2 diabetes. Methods: A total of 136 male individuals, who had been treated in the First Hospital of Qinhuangdao City, were selected to form a new-onset type 2 diabetes group (66 cases) and a control group (70 cases); individuals were divided into three groups (Q1, Q2, and Q3) from low to high according to their anaerobic threshold (AT) oxygen uptake (VO2), AT VO2/kg (VO2 per kg of body weight), peak VO2, peak VO2/kg, AT heart rate (HR), peak HR, and HR recovery after 1 minute. A cardiopulmonary exercise test was used to determine the VO2 of each group of subjects for VO2 max and AT VO2/kg, HR, and HR recovery after 1 minute. The differences in fat areas and plasma glucose levels were compared under different cardiorespiratory endurance indicators. Results: Compared with the control group, the abdominal visceral fat (AVF) area, fasting plasma glucose (FPG), and postprandial plasma glucose (PPG) levels increased in the new-onset type 2 diabetes group. Concurrently, AT VO2, AT VO2/kg, peak VO2, peak VO2/kg, AT HR, peak HR, and 1-minute HR recovery all decreased, and the difference between the groups was statistically significant (P< 0.05). The higher the AT VO2 and peak VO2 values, the lower the PPG level (P< 0.05) and the smaller the area of abdominal visceral fat (P< 0.05). The AT VO2/kg and peak VO2/kg values were negatively correlated with the abdominal visceral fat area, while other indicators had no obvious relationship with either plasma glucose levels or the area of fat. Conclusion: The levels of blood glucose and visceral fat are correlated with cardiopulmonary function. With the increase in blood glucose levels and visceral fat, the indices of cardiopulmonary function gradually decrease. The correlation between different cardiopulmonary function indices and blood glucose levels and visceral fat was different. [ABSTRACT FROM AUTHOR]

Copyright of Progress in Modern Biomedicine is the property of Publishing House of Progress in Modern Biomedicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Open in new tab Download slide Open in new tab Download slide OBJECTIVES Since the introduction of the minimally invasive technique for repair of pectus excavatum (MIRPE), increasing numbers of patients are presenting for surgery. However, controversy remains regarding cardiopulmonary outcomes of surgical repair. Therefore, the aim of our prospective study was to investigate cardiopulmonary function, at rest and during exercise before surgery, first after MIRPE and then after pectus bar removal. METHODS Forty-seven patients were enrolled in a prospective, open-label, single-arm, single-centre clinical trial (Impact of Surgical Treatments of Thoracic Deformation on Cardiopulmonary Function) [NCT02163265] between July 2013 and November 2019. All patients underwent a modified MIRPE technique for surgical correction of pectus excavatum (PE), called Minor Open Videoendoscopically Assisted Repair of Pectus Excavatum. The patients underwent pre- and postoperative chest X-ray, three-dimensional volume-rendering computer tomography thorax imaging, cardiopulmonary function tests at rest and during stepwise cycle spiroergometry (sitting and supine position) and Doppler echocardiography. Daily physical activity questionnaires were also completed. RESULTS The study was completed by 19 patients (15 males, 4 females), aged 13.9–19.6 years at the time of surgery. The surgical patient follow-up was 5.7 ± 7.9 months after pectus bar removal. No significant differences in cardiopulmonary and exercise parameters were seen after placement of the intrathoracic bar, or after pectus bar removal, compared to presurgery. CONCLUSIONS Our findings indicate that surgical correction of PE does not impair cardiopulmonary function at rest or during exercise. Therefore, no adverse effects on exercise performance should be expected from surgical treatment of PE via the modified MIRPE technique. Clinical trial registration number clinicaltrials.gov [ClinicalTrials.gov number, NCT02163265]. [ABSTRACT FROM AUTHOR]

Background: Asthma and/or airway hyper-responsiveness (AHR) are common in elite endurance athletes with a high prevalence rate of beta-2 adrenoreceptor (beta-2) agonists use. Nevertheless, there are data on dose-dependent ergogenic effects of beta-2 agonists suggesting increased muscle strength, endurance and neuromuscular performance. Therefore, most beta-2 agonists belong to the World Anti Doping Agency (WADA) list of prohibited substances and it is tempting to speculate that illegitimate use of beta-2 agonists might be a common practice to boost performance in competitive sports. It is currently unknown whether or not inhaled beta-2 agonists enhance performance by stimulatory effects in skeletal and cardiac muscle.Methods: The ELSA trial is a double-blinded, placebo-controlled, randomized, balanced, four-way cross-over study. Study participants (n=24, 12 ♀, 12 ♂) complete four study arms (i.e. periods with treatment A, placebo; B, salbutamol; C, formoterol; D, formoterol + salbutamol) in random order after an initial preliminary testing session. Participants inhale the study medication 20 min before the 10-min time trial (TT; exercise performance test), where participants cycle 10 min at the highest possible workload. Cardiac output is measured continuously. A skeletal muscle biopsy is collected 3 h after the TT. Study endpoints include measures of skeletal muscle expression of nuclear receptors, hormones and cytokine levels, urinary and plasma concentrations of salbutamol and formoterol, circulating cardiac markers, cardiopulmonary function and exercise performance (average power and peak power during the TT). Blood and urine are collected and respiratory testing is performed 24 h post TT. This clinical trial evaluates the potential performance-enhancing effects of non-prohibited, not medically indicated inhaled short- and long-acting beta-2 agonists on skeletal muscle gene expression, endocrine regulation, cardiac biomarkers, cardiopulmonary function and acute endurance exercise performance. These data will be used by WADA to adapt the annually published list of prohibited substances (WADA 2021) and will be published in scientific journals.Trial Registration: The trial is registered at the European Clinical Trials Database (Eudra CT) with the number: 2015-005598-19 as well as at the German register for clinical studies (DRKS number 00010574 ). [ABSTRACT FROM AUTHOR]

Objectives: Only a small proportion of lung transplant recipients achieve a physical status comparable to healthy individuals in the long term. It is reasonable to hypothesize that the necessary cardiopulmonary adaptation required for strenuous physical exercise may be impaired. Exposure to high altitude provides an optimal platform to study the physiological cardiopulmonary adaptation in lung transplant recipients under aerobic conditions. To gain a deeper understanding, 14 healthy lung transplant recipients and healthcare professionals climbed the highest peak in North Africa (Mount Jebel Toubkal; 4167 m) in September 2019. Methods: Monitoring included daily assessment of vital signs, repeated transthoracic echocardiography, pulmonary function tests, and capillary blood sampling throughout the expedition. Results: Eleven out of fourteen lung transplant recipients reached the summit. All recipients showed a stable lung function and vital parameters and physiological adaptation of blood gases. Similar results were found in healthy controls. Lung transplant recipients showed worse results in the 6‐minute walk test at low and high altitude compared to controls (day 1: 662 m vs. 725 m, p < 0.001, day 5: 656 m vs. 700 m, p = 0.033) and a lack of contractile adaptation of right ventricular function with increasing altitude as measured by tricuspid plane systolic excursion on echocardiography (day 2: 22 mm vs. 24 mm, p = 0.202, day 5: 23 mm vs. 26 mm, p = 0.035). Conclusions: Strenuous exercise in healthy lung transplant recipients is safe. However, the poorer cardiopulmonary performance in the 6‐minute walk test and the lack of right ventricular cardiac adaptation may indicate underlying autonomic dysregulation. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate the relationship between exercise intolerance, muscle oxidative metabolism, and cardiopulmonary function following allogeneic hematopoietic stem cell transplantation (allo-HSCT) in a sterile isolation room setting. Methods: This was a prospective observational cohort study conducted in a single center. Fourteen patients with hematopoietic malignancies who had undergone allo-HSCT were included in this study from June 2015 to April 2020. Patients received donor HSCT after high dose-chemotherapy and total-body irradiation. Physical activity was limited during treatments. Outcome measures included body anthropometric measurements, exercise tolerance tests using the ramp protocol, pulmonary function tests, and near-infrared spectroscopy (NIRS) measurements. Data of pre- and posttransplant measurements were compared using the paired t test or nonparametric Wilcoxon U test. Associations were assessed using the Pearson or nonparametric Spearman correlations. Results: NIRS showed reduced muscle consumption and extraction of oxygen in the posttransplant period compared to the pretransplant period (ΔStO2 min pre: −18.6% vs. post: −13.0%, P = 0.04; ΔHHb max pre: 4.21μmol/l vs. post: 3.31μmol/l: P = 0.048). Exercise tolerance had reduced following allo-HSCT (Peak workload pre: 70.3 W vs. post: 58.0 W: P = 0.014). Furthermore, exercise intolerance was associated with pulmonary function, muscle oxygen consumption, and muscle oxygen extraction (all P <0.05). Conclusion: This analysis revealed that exercise intolerance following allo-HSCT was associated with pulmonary dysfunction and muscle oxidative dysfunction. These findings could help identify the physical function associated with impaired tissue oxygen transport leading to exercise intolerance following allo-HSCT. [ABSTRACT FROM AUTHOR]

Background: Posttraumatic stress disorder (PTSD) has been linked to respiratory symptoms and functional limitations, but the mechanisms leading to this association are poorly defined.Research Question: What is the relationship between PTSD, lung function, and the cardiopulmonary response to exercise in combat veterans presenting with chronic respiratory symptoms?Study Design and Methods: This study prospectively enrolled military service members with respiratory symptoms following deployment to southwest Asia. All participants underwent a comprehensive evaluation that included pulmonary function testing and cardiopulmonary exercise testing. Pulmonary function test variables and cardiopulmonary response to exercise were compared in subjects with and without PTSD by using multivariable linear regression to adjust for confounders.Results: A total of 303 participants were included (PTSD, n = 70; non-PTSD, n = 233). Those with PTSD had a greater frequency of current respiratory symptoms. There were no differences in measures for airway disease or lung volumes, but patients with PTSD had a reduction in diffusing capacity that was eliminated following adjustment for differences in hemoglobin levels. Participants with PTSD had a lower anaerobic threshold (23.9 vs 26.4 cc/kg per minute; P = .004), peak oxygen pulse (19.7 vs 18.5 cc/beat; P = .03), and peak oxygen uptake (34.5 vs 38.8 cc/kg per minute; P < .001). No significant difference was observed in gas exchange, respiratory reserve, or effort at peak exercise between participants with and without PTSD.Interpretation: A diagnosis of PTSD was associated with a reduced anaerobic threshold, oxygen pulse, and peak oxygen uptake. This objective reduction in cardiopulmonary work is independent of baseline lung function, was not associated with abnormalities in gas exchange or respiratory reserve, and may be related to deconditioning. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: Physical activity in children and adolescents has positive effects on cardiopulmonary function in this age group as well as later in life. As poor cardiopulmonary function is associated with higher mortality and morbidity, increasing physical activity especially in children needs to become a priority. Trampoline jumping is widely appreciated in children. The objective was to investigate its use as a possible training modality. Methods: Fifteen healthy children (10 boys and 5 girls) with a mean age of 8.8 years undertook one outdoor incremental running test using a mobile cardiopulmonary exercise testing unit. After a rest period of at least 2 weeks, a trampoline test using the mobile unit was realized by all participants consisting of a 5-min interval of moderate-intensity jumping and two high-intensity intervals with vigorous jumping for 2 min, interspersed with 1-min rests. Results: During the interval of moderate intensity, the children achieved V ̇ O 2 -values slightly higher than the first ventilatory threshold (VT1) and during the high-intensity interval comparable to the second ventilatory threshold (VT2) of the outdoor incremental running test. They were able to maintain these values for the duration of the respective intervals. The maximum values recorded during the trampoline test were significantly higher than during the outdoor incremental running test. Conclusion: Trampoline jumping is an adequate tool for implementing high-intensity interval training as well as moderate-intensity continuous training in children. As it is a readily available training device and is greatly enjoyed in this age group, it could be implemented in exercise interventions. [ABSTRACT FROM AUTHOR]

Open in new tab Download slide Open in new tab Download slide OBJECTIVES The frequency of sternochondroplasty in cases of pectus carinatum (PC) has increased due to greater surgeon experience and modified surgical techniques. PC deformity does not usually cause cardiopulmonary malfunction or impairment. However, whether cardiopulmonary function changes after surgical repair remains a matter of controversy. The aim of our prospective study was to determine if surgery changes preoperative cardiopulmonary function. METHODS Nineteen patients (16 males, 3 females) were enrolled in a prospective, open-label, single-arm, single-centre clinical trial (Impact of Surgical Treatments of Thoracic Deformation on Cardiopulmonary Function) (NCT02163265) between July 2013 and January 2017. All patients underwent PC repair via a modified Ravitch procedure and wore a lightweight, patient-controlled chest brace for 8 weeks postoperatively (the Innsbruck protocol). The average follow-up surgical examination was 8.3 months after surgery. In all enrolled patients, before surgery and not before 6 months postoperatively chest X-ray, 3-dimensional volume-rendered computed tomography thorax imaging, cardiopulmonary function tests with stepwise cycle spiroergometry (sitting and supine position) and Doppler echocardiography were performed; questionnaires about daily physical activity were also completed. RESULTS Fourteen patients (aged 16.3 ± 2.6 years at study entry) completed the study. Changes in submaximal and peak power output were not detected during sitting, or when in the supine position. Also, no clinically relevant postoperative changes in spirometry or echocardiography were noted. CONCLUSIONS Our findings confirm that surgical correction of PC does not impair cardiopulmonary function at rest or during physical exercise. Clinical registration number clinicaltrials.gov NCT02163265. [ABSTRACT FROM AUTHOR]

Instrumental activities of daily living (IADL) are significantly related to quality of life and mortality among individuals with heart disease. However, few reports have examined IADL in persons with chronic thromboembolic pulmonary hypertension (CTEPH). The aim of this study was to clarify factors related to IADL in persons with CTEPH. This retrospective, observational study enrolled 163 persons with CTEPH (mean ± standard deviation age = 65 ± 13 years; 68% female) admitted to the Department of Cardiology at Keio University Hospital between January 2015 and July 2019. The Frenchay Activities Index (FAI) was used to assess IADL. Age, sex, body mass index, World Health Organization functional class (WHO-FC), cardiac function (mean pulmonary arterial pressure, mean right atrial pressure, pulmonary capillary wedge pressure, and cardiac index), pulmonary function (percentage vital capacity, percentage forced expiratory volume in 1 s, diffusion capacity of carbon monoxide (DLCO)/alveolar volume (VA)), physical function (knee extension strength and walking speed), and 6-min walking distance (6MWD) were assessed. Multiple regression analysis was performed to identify factors significantly associated with FAI. Mean FAI was 25 ± 8. Univariate analysis showed that sex, WHO-FC, DLCO/VA, walking speed, and 6MWD were correlated with FAI. Multiple regression analysis showed that 6MWD (sβ = 0.338, 95% CI 0.014–0.034, p <.001), sex (sβ = 0.268, 95% CI 2.238–7.165, p <.001), and DLCO/VA (sβ = 0.257, 95% CI 1.011–3.528, p <.001) were significantly correlated with FAI (R 2 = 0.261). IADL were associated with exercise tolerance, sex, and DLCO/VA in persons with CTEPH. In the future, more details of IADL are expected to be clarified by analyzing individual components of IADL and investigating social background characteristics, including living environment. [ABSTRACT FROM AUTHOR]

The lung function laboratory frequently provides relevant information to the practice of pulmonology. Clinical interpretation of pulmonary function and exercise tests, however, has been complicated more recently by temporal changes in demographic characteristics (higher life expectancy), anthropometric attributes (increased obesity prevalence), and the surge of polypharmacy in a sedentary population with multiple chronic degenerative diseases. In this narrative review, we concisely discuss some key challenges to test interpretation that have been affected by these epidemiologic shifts: (a) the confounding effects of advanced age and severe obesity, (b) the contemporary controversies in the diagnosis of obstruction (including asthma and/or COPD), (c) the importance of considering the diffusing capacity of the lung for carbon monoxide (Dlco)/"accessible" alveolar volume (carbon monoxide transfer coefficient) in association with Dlco to uncover the causes of impaired gas exchange, and (d) the modern role of the pulmonary function laboratory (including cardiopulmonary exercise testing) in the investigation of undetermined dyspnea. Following a Bayesian perspective, we suggest interpretative algorithms that consider the pretest probability of abnormalities as indicated by additional clinical information. We, therefore, adopt a pragmatic approach to help the practicing pulmonologist to apply the information provided by the lung function laboratory to the care of individual patients. [ABSTRACT FROM AUTHOR]