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7. Serial cardiopulmonary exercise testing in young patients after one-and-half ventricle repair and Fontan procedure: a comparative study

Author

Vecchiato, Marco, primary, Mazzucato, Barbara, additional, Battista, Francesca, additional, Neunhaeuserer, Daniel, additional, Quinto, Giulia, additional, Aghi, Andrea, additional, Varnier, Maurizio, additional, Gasperetti, Andrea, additional, Di Salvo, Giovanni, additional, Vida, Vladimiro, additional, Padalino, Massimo Antonio, additional, and Ermolao, Andrea, additional

Published
2024
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13. The “Aging Effect” of BMI on Cardiorespiratory Fitness: A New Insight on Functional Evaluation in Obesity

Author

Battista, Francesca, primary, Neunhaeuserer, Daniel, additional, Centanini, Anna, additional, Gasperetti, Andrea, additional, Quinto, Giulia, additional, Vecchiato, Marco, additional, Bianchi, Elia, additional, Frigo, Anna Chiara, additional, Bettini, Silvia, additional, Vettor, Roberto, additional, Busetto, Luca, additional, and Ermolao, Andrea, additional

Published
2023
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14. The Fragmented QRS Complex in Lead V1: Time for an Update of the Athlete's ECG?

Author

Vecchiato, Marco, Quinto, Giulia, Borasio, Nicola, Palermi, Stefano, Berton, Giampaolo, Battista, Francesca, Gasperetti, Andrea, Ermolao, Andrea, and Neunhaeuserer, Daniel

Abstract

Differentiating between ECG patterns related to athletes' heart remodeling and pathological findings is a challenge in sports cardiology. As the significance of fragmented complex in athletes remains uncertain, this study aimed to assess the presence of fragmented QRS in lead V1 (fQRSV1) among young athletes and its association with heart adaptations and arrhythmias. Young athletes referred for annual pre-participation screening receiving a maximal exercise testing and transthoracic echocardiography from January 2015 to March 2021 were included. The study included 684 young athletes. The prevalence of fQRSV1 was 33%. Subjects with fQRSV1 had higher exercise capacity and indexes of right ventricular function and remodeling. Among highly trained athletes, the fQRSV1 group demonstrated also increased left ventricular wall thickness. No significant association existed between fQRSV1 and exercise-induced arrhythmias, even in highly trained athletes. The high prevalence of fQRSV1 in young athletes is associated with training-induced heart adaptations but not exercise-induced ventricular arrhythmias. The fragmented QRS complex in lead V1 in young athletes. PPS = preparticipation screening; EST = exercise stress test; fQRSV1 = fragmented QRS in lead V1; PSBs = premature supraventricular beats; PVBs = premature ventricular beats. [ABSTRACT FROM AUTHOR]

Published
2024
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21. Overshoot of the Respiratory Exchange Ratio during Recovery from Maximal Exercise Testing in Young Patients with Congenital Heart Disease

Author

Vecchiato, Marco, primary, Ermolao, Andrea, additional, Zanardo, Emanuele, additional, Battista, Francesca, additional, Ruvoletto, Giacomo, additional, Palermi, Stefano, additional, Quinto, Giulia, additional, Degano, Gino, additional, Gasperetti, Andrea, additional, Padalino, Massimo A., additional, Di Salvo, Giovanni, additional, and Neunhaeuserer, Daniel, additional

Published
2023
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25. Edmonton Obesity Staging System: an improvement by cardiopulmonary exercise testing

Author

Bettini, Silvia, Quinto, Giulia, Neunhaeuserer, Daniel, Battista, Francesca, Belligoli, Anna, Milan, Gabriella, Gasperetti, Andrea, Vettor, Roberto, Ermolao, Andrea, and Busetto, Luca

Abstract

Background/Objectives: Different approaches are used to classify obesity severity. Beyond classical anthropometric measurements, the Edmonton Obesity Staging System (EOSS) considers medical, physical and psychological parameters. However, this method has some limitations, principally due to the absence of an objective measure for physical impairment. The aim of our study is thus to overcome this limitation suggesting a new functional parameter obtained by cardiopulmonary exercise testing (CPET), i.e., cardiorespiratory fitness (CRF), expressed as weight-adjusted peak oxygen consumption (VO2peak/kg). Subjects/Methods: This observational cross-sectional study conducted on a population of 843 patients affected by obesity finally enrolled 500 subjects. Every patient underwent clinical, anthropometric, biochemical assessment and CPET. First, participants have been classified according to standard EOSS in five stages. Second, patients were reclassified according to the new modified EOSS (EOSS-CRF) based on their age- and gender-appropriate VO2peak/kg percentiles as reported in the healthy normal-weight population of the FRIEND registry. Results: VO2peak/kg was significantly different between standard EOSS classes 1 and 2 and classes 1 and 3 (ANCOVA pmodel = 0.004), whereas patients in classes 2 and 3 showed similar CRF. The EOSS-CRF classification varied in number of patients in each class compared to EOSS, particularly with a shift from class 2 to class 3. Moreover, CRF showed that physical impairment is less addressed by EOSS when compared to EOSS-CRF. Conclusions: The integration of EOSS with CRF allowed us to assign to each patient a severity index that considers not only clinical parameters, but also their functional impairment through a quantitative and prognostically important parameter (VO2peak/kg). This improvement of the staging system may also provide a better approach to identify individuals at increased risk of mortality leading to targeted therapeutic management and prognostic risk stratification for patients with obesity.

Published
2024
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27. Do Androgenic Pattern, Insulin State and Growth Hormone Affect Cardiorespiratory Fitness and Strength in Young Women with PCOS?

Author

Baioccato, Veronica, primary, Quinto, Giulia, additional, Rovai, Sara, additional, Conte, Francesca, additional, Dassie, Francesca, additional, Neunhäeuserer, Daniel, additional, Vecchiato, Marco, additional, Palermi, Stefano, additional, Gasperetti, Andrea, additional, Bullo, Valentina, additional, Camozzi, Valentina, additional, Vettor, Roberto, additional, Ermolao, Andrea, additional, and Mioni, Roberto, additional

Published
2022
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30. Exercise Capacity and Cardiorespiratory Fitness in Children with Congenital Heart Diseases: A Proposal for an Adapted NYHA Classification

Author

Neunhaeuserer, Daniel, primary, Battista, Francesca, additional, Mazzucato, Barbara, additional, Vecchiato, Marco, additional, Meneguzzo, Giulia, additional, Quinto, Giulia, additional, Niebauer, Josef, additional, Gasperetti, Andrea, additional, Vida, Vladimiro, additional, Di Salvo, Giovanni, additional, Varnier, Maurizio, additional, and Ermolao, Andrea, additional

Published
2022
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33. Can exercise test intensity and modality affect the prevalence of arrhythmic events in young athletes?

Author

Quinto, Giulia, Neunhaeuserer, Daniel, Gasperetti, Andrea, Battista, Francesca, Foccardi, Giulia, Baioccato, Veronica, Gobbo, Stefano, Bergamin, Marco, and Ermolao, Andrea

Subjects
ATHLETES, EXERCISE intensity, ARRHYTHMIA
Abstract

Pre-participation screening is performed to identify underlying cardiac conditions that may also lead to sudden cardiac death. Our aim is to compare submaximal Harvard Step Test (HST) with incremental Maximal Exercise Test (MET) on treadmill to induce and detect arrhythmias in younger athletes. A total of 1000 athletes (mean age 14.6 ± 4.7 years) were evaluated, 500 with MET and 500 with HST, all with continuous ECG monitoring until three minutes of recovery. Pre-test evaluation includes medical history, clinical evaluation and resting electrocardiogram. Ventricular and/or supraventricular arrhythmias were observed in 2.6% of athletes performing HST and in 8.4% during MET (p < 0.001). Incidence of arrhythmias remained higher for MET also considering separately exercise phase (0.8% vs. 5.2%; p < 0.001) and recovery phase (2.0% vs. 6.0%; p < 0.01). No gender differences were observed. Results suggest that MET induces more arrhythmias than submaximal HST, regardless of test phase. Higher test intensity and longer exercise duration might influence test outcomes, making MET more arrhythmogenic. [ABSTRACT FROM AUTHOR]

Published
2023
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38. Metabolic Response to Submaximal and Maximal Exercise in People with Severe Obesity, Prediabetes, and Diabetes

Author

Battista, Francesca, primary, Belligoli, Anna, additional, Neunhaeuserer, Daniel, additional, Gasperetti, Andrea, additional, Bettini, Silvia, additional, Compagnin, Chiara, additional, Marchese, Riccardo, additional, Quinto, Giulia, additional, Bergamin, Marco, additional, Vettor, Roberto, additional, Busetto, Luca, additional, and Ermolao, Andrea, additional

Published
2021
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43. Cardiorespiratory function and VO2 kinetics after sleeve gastrectomy: a follow-up analysis

Author

Neunhaeuserer Daniel, Belligoli Anna, Vettor Roberto, Busetto Luca, Campi Cristina, Savalla Francesco, Foletto Mirto, Ermolao Andrea, Bergamin Marco, Rami Anna, Gasperetti Andrea, and Gobbo Stefano

Subjects
Bariatric surgery, medicine.medical_specialty, Sleeve gastrectomy, Oxygen uptake kinetics, business.industry, medicine.medical_treatment, Cardiopulmonary exercise test, Cardiorespiratory fitness, 030204 cardiovascular system & hematology, Muscle mass, Oxygen uptake, Peripheral, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Emergency Medicine, Internal Medicine, Cardiology, Medicine, In patient, 030212 general & internal medicine, business, Vo2 kinetics, Aerobic capacity
Abstract

Although poor cardiorespiratory function is a powerful predictor of mortality in patients with obesity, functional evaluation has been given little attention after laparoscopic sleeve gastrectomy (LSG). The aim of this study was thus to investigate the impact of LSG on functional capacity analysing a shorter and longer post-surgical follow-up. In this observational study, 24 patients with severe obesity (BMI 44.04 ± 5.84 kg/m2, age 47.0 ± 9.0 years) performed cardiopulmonary exercise testing 7 months pre-, 6 and 16 months post-LSG. Exercise capacity, oxygen uptake and VO2 kinetics were analysed during treadmill exercise testing. Although patients showed an improved peak work capacity after LSG, parameters of maximal absolute aerobic capacity demonstrated a significant decrease, which was confirmed also in the follow-up analysis. Furthermore, the time constant Tau (τ) of the fundamental component of VO2 kinetics was altered by LSG, however, within the 16 months of follow-up it returned towards baseline values. It can thus be concluded that LSG improved peak work capacity along with a lower maximal absolute aerobic capacity, which might be due to a loss of muscle mass and potentially impaired peripheral oxidative muscle metabolism. However, VO2 kinetics might suggest an initial restoration of peripheral oxidative muscle capacity after a longer follow-up.

Published
2020

44. Cardiorespiratory function and VO

Author

Neunhaeuserer, Daniel, Savalla, Francesco, Gasperetti, Andrea, Rami, Anna, Gobbo, Stefano, Campi, Cristina, Belligoli, Anna, Busetto, Luca, Foletto, Mirto, Vettor, Roberto, Bergamin, Marco, and Ermolao, Andrea

Subjects
Male, Oxygen, Exercise Tolerance, Gastrectomy, Exercise Test, Humans, Female, Laparoscopy, Longitudinal Studies, Middle Aged, Follow-Up Studies, Obesity, Morbid
Abstract

Although poor cardiorespiratory function is a powerful predictor of mortality in patients with obesity, functional evaluation has been given little attention after laparoscopic sleeve gastrectomy (LSG). The aim of this study was thus to investigate the impact of LSG on functional capacity analysing a shorter and longer post-surgical follow-up. In this observational study, 24 patients with severe obesity (BMI 44.04 ± 5.84 kg/m

Published
2019

45. Arterial switch operation for transposition of the great arteries: A single‐centre 32‐year experience

Author

Vida, Vladimiro L., primary, Zanotto, Lorenza, additional, Zanotto, Lucia, additional, Triglia, Laura T., additional, Bellanti, Ermanno, additional, Castaldi, Biagio, additional, Padalino, Massimo A., additional, Gasperetti, Andrea, additional, Battista, Francesca, additional, Varnier, Maurizio, additional, and Stellin, Giovanni, additional

Published
2019
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48. A clinical evaluation of VO2 kinetics in kidney transplant recipients.

Author

Patti, Alessandro, Neunhaeuserer, Daniel, Ortolan, Sara, Roman, Fausto, Gasperetti, Andrea, Battista, Francesca, Di Bella, Caterina, Gobbo, Stefano, Bergamin, Marco, Furian, Lucrezia, and Ermolao, Andrea

Subjects
KIDNEY transplantation, AEROBIC capacity, OXYGEN consumption, EXERCISE tests, CHRONIC kidney failure
Abstract

Purpose: Aerobic exercise capacity is reduced in patients with chronic kidney disease, partly due to alterations at the muscular and microvascular level. This study evaluated oxygen uptake (VO2) kinetics as indicator of muscular oxidative metabolism in a population of Kidney Transplant Recipients (KTRs).Methods: Two groups of KTRs enrolled 3 (n = 21) and 12 months (n = 14) after transplantation and a control group of healthy young adults (n = 16) underwent cardiopulmonary exercise testing on cycle-ergometer. The protocol consisted in two subsequent constant, moderate-load exercise phases with a final incremental test until exhaustion.Results: The time constant of VO2 kinetics was slower in KTRs at 3 and 12 months after transplantation compared to controls (50.4 ± 13.1 s and 43.8 ± 11.6 s vs 28.9 ± 8.4 s, respectively; P < 0.01). Peak VO2 was lower in KTRs evaluated 3 months after transplantation compared to patients evaluated after 1 year (21.3 ± 4.3 and 26.4 ± 8.0 mL/kg/min; P = 0.04). Blood haemoglobin (Hb) concentration was higher in KTRs evaluated at 12 months (12.8 ± 1.7 vs 14.6 ± 1.7 g/dL; P < 0.01). Among KTRs, τ showed a moderate negative correlation with Peak VO2 (ρ = - 0.52) and Oxygen uptake efficiency slope (OUES) (r = - 0.57) while no significant correlation with Hb and peak heart rate.Conclusions: KTRs show slower VO2 kinetics compared to healthy controls. Hb and peak VO2 seem to improve during the first year after transplantation. VO2 kinetics were significantly associated with indices of cardiorespiratory fitness, but less with central determinants of aerobic capacity, thus suggesting a potential usefulness of adding this index of muscular oxidative metabolism to functional evaluation in KTRs. [ABSTRACT FROM AUTHOR]

Published
2021
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