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The purpose of this study was to determine and compare the effectiveness of three different resistance training (RT) methods for cardiac rehabilitation., SCOPUS: ar.j, info:eu-repo/semantics/published

Cardiopulmonary exercise testing (CPET) was limited to peak oxygen consumption analysis (VO2peak), and now the ventilation/carbon dioxide production (VE/VCO2) slope is recognized as having independent prognostic value. Unlike VO2peak, the VE/VCO2 slope does not require maximal effort, making it more feasible. There is no consensus on how to measure the VE/VCO2 slope; therefore, we assessed whether different methods affect its value. This is a retrospective study assessing sociodemographic data, left ventricular ejection fraction, CPET parameters, and indications of patients referred for CPET. The VE/VCO2 slope was measured to the first ventilatory threshold (VT1-slope), secondary threshold (VT2-slope), and included all test data (full-slope). Of the 697 CPETs analyzed, 308 reached VT2. All VE/VCO2 slopes increased with age, regardless of test indications. In patients not reaching VT2, the VT1-slope was 32 vs. 36 (p < 0.001) for the full-slope; in those surpassing VT2, the VT1-slope was 29 vs. 33 (p < 0.001) for the VT2-slope and 37 (all p < 0.001) for the full-slope. The mean difference between the submaximal and full-slopes was ±4 units, sufficient to reclassify patients from low to high risk for heart failure or pulmonary hypertension. We conclude that the method used for determining the VE/VCO2 slope greatly influences the result, the significant variations limiting its prognostic value. The calculation method must be standardized to improve its prognostic value., SCOPUS: ar.j, info:eu-repo/semantics/published

Obesity might be a cause of limited aerobic exercise capacity. It is often associated with metabolic syndrome (MS) that includes cardiovascular comorbidities as arterial hypertension. Cardiopulmonary exercise testing (CPET) is the gold-standard to assess aerobic capacity and discriminate causes of dyspnea., SCOPUS: ar.j, info:eu-repo/semantics/published

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Funding Acknowledgements Type of funding sources: None. The Cardiopulmonary exercise testing (CPET) is the gold standard for cardiorespiratory and metabolic function at exercise. This CPEThighlight the limiting factors, but also provides prognostic indicators. Among the prognostic factors, maximal oxygen uptake (peak VO2) has been used for many years, particularly in heart failure, but some studies have highlighted the limitations of isolated use of peak VO2. The measurement of the Ve / VCO2 slope is currently recognized as having a complementary prognostic value. However, the manner of determining the Ve / VCO2 slope is not universally established. A single CPET could therefore deliver several slope measurements depending on the method used to calculate it. This lack of clarity would lead to possible variations affecting the reflection of the severity of the disease or the prognostic power of this parameter. Our work consisted in calculating and comparing, over nearly 700 successive CPET, the slope Ve / VCO2: 1) by calculating it up to SV1, 2) by calculating it up to SV2, 3) by the calculating on all the data beyond SV2 (in the 44% of patients in whom SV2 could be determined). The patients were classified according to the indication of the examination in 1) cardiac (54%), 2) pulmonary (15%), 3) dyspnea assessment (10%) and 4) various (oncology, obesity, diabetes, rheumatic disease: 21%). The "cardiac" category was subdivided into HTP, IC, operated CPI and non operated CPI) (results not detailed in this abstract). We have found systematic and significant differences depending on how the slope is calculated. On the whole population: in patients who did not reach SV2 (n = 389), the Ve / VCO2 slope reaches 33.8 +/- 8.5 when it is calculated up to SV1 while it reaches 38.5 + / - 8.7 (p <0.001) when it is calculated over the entire CPET. On the whole population: in patients with SV2 (n = 308), the Ve / VCO2 slope reaches 29.4 +/- 5.9 when it is calculated up, info:eu-repo/semantics/published

Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): Fonds Erasme pour la recherche médicale Background/Introduction The hemodynamic response to strength training depends on the intensity, the time of rest between exercise sets and the duration of the exercise (1-3). A new method (the ‘3/7 method’), which consist of 5 successive sets of exercise with an increasing number of repetitions (3 to 7) separated by brief inter-set rest intervals (15 s), achieved a greater and faster strength gain after 12 weeks of training in young healthy subjects (4-5) (Fig 1). Further characterization of the tolerability of 3/7 method, as well as rise in blood pressure (BP) and heart rate (HR) it may induce, is needed in a patient population before this methodology can be applied in cardiac rehabilitation centers (6). These parameters were compared to those induced by 3 series of 9 repetitions (‘3X9 method’) with a longer inter-set rest interval (1min), using a randomized and cross-over study design. Purpose This study investigated the Borg scale and hemodynamic response of the 3/7 vs. 3X9 strength training methods in heart failure patients with reduced ejection fraction (HFrEF, Left ventricular ejection fraction (LVEF) < 40%) and patients with coronary artery disease (LVEF> 40%, CAD). Method 23 HFrEF (58±9 y, 13% female) and 22 CAD (64±10 y, 14% female) participated in the study. CAD underwent revascularization between 1 and 6 months prior to the study. Patients with decompensated heart failure, atrial fibrillation, major orthopedics disabilities were not included in the study. The strength training consisted in leg extension against a load of ~ 70% of 1 repetition maximal (1RM). Perceived exertion was also assessed at the end of the last set by using the modified Borg Scale (0-10). HR and BP were assessed noninvasively beat by beat (Task Force Monitor). We compared baseline and peak exercise values in each group. All participants signed a, info:eu-repo/semantics/published

Our aim was to evaluate the benefits of cardio-pulmonary rehabilitation on severe to moderate COVID-19 patients. 25 discharged COVID-19 patients underwent a cardio-pulmonary test (CPET), a spirometry test and a measure of carbon monoxide lung diffusion capacity (DLCO) at the beginning of their rehabilitation program and after 23 ± 5 rehabilitation sessions. This rehabilitation program combined interval training exercises on a bike and resistance exercises for major muscle groups. We then compared their progress in rehabilitation to that obtained with cardiac patients. At the beginning of their rehabilitation program, COVID-19 patients presented a reduced physical capacity with a maximal aerobic capacity (VO2 max) at 71% of predicted value, a maximal workload at 70% of predicted value and an exercise hyperventilation measured by a higher VE/VCO2 slope. Exercise was mainly limited by muscle deconditioning. After rehabilitation, the VO2 max and maximal workload increased in COVID 19 patients by 18% and 26%, respectively. In patients with ischemic heart disease the post-rehabilitation gains in VO2 max and maximal workload were 22% and 25%, respectively. Moreover, exercise hyperventilation decreased by 10% in both groups. On the other hand, the intrinsic pulmonary function of COVID 19 patients improved following natural recovery. In conclusion, even if cardio-pulmonary rehabilitation is probably not the only parameter which explains the partial recovery of moderate to severe COVID-19 patients, it certainly helps to improve their physical capacity and reduce exercise hyperventilation., SCOPUS: ar.j, info:eu-repo/semantics/published

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Whereas exercise training is key in the management of patients with cardiovascular disease (CVD) risk (obesity, diabetes, dyslipidaemia, hypertension), clinicians experience difficulties in how to optimally prescribe exercise in patients with different CVD risk factors. Therefore, a consensus statement for state-of-the-art exercise prescription in patients with combinations of CVD risk factors as integrated into a digital training and decision support system (the EXercise Prescription in Everyday practice & Rehabilitative Training (EXPERT) tool) needed to be established. EXPERT working group members systematically reviewed the literature for meta-analyses, systematic reviews and/or clinical studies addressing exercise prescriptions in specific CVD risk factors and formulated exercise recommendations (exercise training intensity, frequency, volume and type, session and programme duration) and exercise safety precautions, for obesity, arterial hypertension, type 1 and 2 diabetes, and dyslipidaemia. The impact of physical fitness, CVD risk altering medications and adverse events during exercise testing was further taken into account to fine-tune this exercise prescription. An algorithm, supported by the interactive EXPERT tool, was developed by Hasselt University based on these data. Specific exercise recommendations were formulated with the aim to decrease adipose tissue mass, improve glycaemic control and blood lipid profile, and lower blood pressure. The impact of medications to improve CVD risk, adverse events during exercise testing and physical fitness was also taken into account. Simulations were made of how the EXPERT tool provides exercise prescriptions according to the variables provided. In this paper, state-of-the-art exercise prescription to patients with combinations of CVD risk factors is formulated, and it is shown how the EXPERT tool may assist clinicians. This contributes to an appropriately tailored exercise regimen for every CVD risk patient., SCOPUS: re.j, info:eu-repo/semantics/published

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