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Panaioli E, Khraiche D, Derridj N, Bonnet D, Raimondi F, Legendre A. Rightward imbalanced pulmonary perfusion predicts better exercise stroke volume in children after Fallot repair. Arch Cardiovasc Dis 2023; 116:373-381. [PMID: 37422422 DOI: 10.1016/j.acvd.2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 06/07/2023] [Accepted: 06/08/2023] [Indexed: 07/10/2023]
Abstract
BACKGROUND Residual lesions following Fallot repair are primarily pulmonary regurgitation and right ventricular outflow tract obstruction. These lesions may impact exercise tolerance, particularly because of a poor increase in left ventricular stroke volume. Pulmonary perfusion imbalance is also common, but its effect on cardiac adaptation to exercise is not known. AIM To assess the association between pulmonary perfusion asymmetry and peak indexed exercise stroke volume (pSVi) in young patients. METHODS We retrospectively studied 82 consecutive patients with Fallot repair (mean age 15.2±3.8 years) who underwent echocardiography, four-dimensional flow magnetic resonance imaging and cardiopulmonary testing with pSVi measurement by thoracic bioimpedance. Normal pulmonary flow distribution was defined as right pulmonary artery perfusion between 43 and 61%. RESULTS Normal, rightward and leftward flow distributions were found in 52 (63%), 26 (32%) and four (5%) patients, respectively. Independent predictors of pSVi were right pulmonary artery perfusion (β=0.368, 95% confidence interval [CI] 0.188 to 0.548; P=0.0003), right ventricular ejection fraction (β=0.205, 95% CI 0.026 to 0.383; P=0.049), pulmonary regurgitation fraction (β=-0.283, 95% CI -0.495 to -0.072; P=0.006) and Fallot variant with pulmonary atresia (β=-0.213, 95% CI -0.416 to -0.009; P=0.041). The pSVi prediction was similar when the categorical variable right pulmonary artery perfusion>61% was used (β=0.210, 95% CI 0.006 to 0.415; P=0.044). CONCLUSION In addition to right ventricular ejection fraction, pulmonary regurgitation fraction and Fallot variant with pulmonary atresia, right pulmonary artery perfusion is a predictor of pSVi, in that rightward imbalanced pulmonary perfusion favours greater pSVi.
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Affiliation(s)
- Elena Panaioli
- Cardiologie pédiatrique, M3C-Necker, hôpital universitaire Necker-enfants malades, AP-HP, 149, rue de Sèvres, 75743 Paris cedex 15, France; Radiology Department, hôpital universitaire Necker-enfants malades, AP-HP, 75743 Paris, France
| | - Diala Khraiche
- Cardiologie pédiatrique, M3C-Necker, hôpital universitaire Necker-enfants malades, AP-HP, 149, rue de Sèvres, 75743 Paris cedex 15, France
| | - Neil Derridj
- Cardiologie pédiatrique, M3C-Necker, hôpital universitaire Necker-enfants malades, AP-HP, 149, rue de Sèvres, 75743 Paris cedex 15, France
| | - Damien Bonnet
- Cardiologie pédiatrique, M3C-Necker, hôpital universitaire Necker-enfants malades, AP-HP, 149, rue de Sèvres, 75743 Paris cedex 15, France; Paris Cité University, 75006 Paris, France
| | - Francesca Raimondi
- Cardiologie pédiatrique, M3C-Necker, hôpital universitaire Necker-enfants malades, AP-HP, 149, rue de Sèvres, 75743 Paris cedex 15, France; Radiology Department, hôpital universitaire Necker-enfants malades, AP-HP, 75743 Paris, France; Paris Cité University, 75006 Paris, France
| | - Antoine Legendre
- Cardiologie pédiatrique, M3C-Necker, hôpital universitaire Necker-enfants malades, AP-HP, 149, rue de Sèvres, 75743 Paris cedex 15, France.
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Pasetes LN, Rosendahl-Garcia KM, Goel N. Cardiovascular measures display robust phenotypic stability across long-duration intervals involving repeated sleep deprivation and recovery. Front Neurosci 2023; 17:1201637. [PMID: 37547137 PMCID: PMC10397520 DOI: 10.3389/fnins.2023.1201637] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 07/03/2023] [Indexed: 08/08/2023] Open
Abstract
Introduction We determined whether cardiovascular (CV) measures show trait-like responses after repeated total sleep deprivation (TSD), baseline (BL) and recovery (REC) exposures in two long-duration studies (total N = 11 adults). Methods A 5-day experiment was conducted twice at months 2 and 4 in a 4-month study (N = 6 healthy adults; 3 females; mean age ± SD, 34.3 ± 5.7 years; mean BMI ± SD, 22.5 ± 3.2 kg/m2), and three times at months 2, 4, and 8 in an 8-month study (N = 5 healthy adults; 2 females; mean age ± SD, 33.6 ± 5.17 years; mean BMI ± SD, 27.1 ± 4.9 kg/m2). Participants were not shift workers or exposed to TSD in their professions. During each experiment, various seated and standing CV measures were collected via echocardiography [stroke volume (SV), heart rate (HR), cardiac index (CI), left ventricular ejection time (LVET), and systemic vascular resistance index (SVRI)] or blood pressure monitor [systolic blood pressure (SBP)] after (1) two BL 8h time in bed (TIB) nights; (2) an acute TSD night; and (3) two REC 8-10 h TIB nights. Intraclass correlation coefficients (ICCs) assessed CV measure stability during BL, TSD, and REC and for the BL and REC average (BL + REC) across months 2, 4, and 8; Spearman's rho assessed the relative rank of individuals' CV responses across measures. Results Seated BL (0.693-0.944), TSD (0.643-0.962) and REC (0.735-0.960) CV ICCs showed substantial to almost perfect stability and seated BL + REC CV ICCs (0.552-0.965) showed moderate to almost perfect stability across months 2, 4, and 8. Individuals also exhibited significant, consistent responses within seated CV measures during BL, TSD, and REC. Standing CV measures showed similar ICCs for BL, TSD, and REC and similar response consistency. Discussion This is the first demonstration of remarkably robust phenotypic stability of a number of CV measures in healthy adults during repeated TSD, BL and REC exposures across 2, 4, and 8 months, with significant consistency of responses within CV measures. The cardiovascular measures examined in our studies, including SV, HR, CI, LVET, SVRI, and SBP, are useful biomarkers that effectively track physiology consistently across long durations and repeated sleep deprivation and recovery.
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Affiliation(s)
- Lauren N. Pasetes
- Biological Rhythms Research Laboratory, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
| | | | - Namni Goel
- Biological Rhythms Research Laboratory, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
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Müller N, Herberg U, Jung T, Breuer J, Härtel JA. Adequate exercise response at artificial altitude in Fontan patients. Front Pediatr 2022; 10:947433. [PMID: 36061398 PMCID: PMC9433899 DOI: 10.3389/fped.2022.947433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 07/21/2022] [Indexed: 11/13/2022] Open
Abstract
PURPOSE For Fontan-palliated patients, altitude exposure is still a part of discussion since the extent of hypoxic pulmonary vasoconstriction potentially resulting in decreasing cardiac output (Qc), especially during physical exercise, is still unclear. We investigated the effects of normobaric hypoxia (15.2% O2) simulating 2,500 m above sea level on cardiopulmonary and metabolic parameters and the benefit of daily physical activity (PA) on hypoxic exercise capacity. METHODS A total of 21 Fontan patients (14-31 years) and 20 healthy controls performed cardiopulmonary exercise tests on a bicycle ergometer in normoxia and hypoxia until subjective exhaustion, measuring capillary lactate (cLa) every 2 min. In between, participants underwent an activity tracking over 5 days with a triaxial accelerometer. RESULTS Hypoxic exercise was well tolerated by Fontan patients, and no adverse clinical events were observed. Fontan patients showed reduced physical capacity under both conditions compared to controls (63% normoxia, 62% hypoxia), but the relative impairment due to hypoxia was similar for both (≈10%). Up to workloads of 2 W/kg oxygen uptake ( V . O2) and heart rate (HR) developed similarly in patients and controls. cLa increased faster in relation to workload in Fontan patients, but remained significantly lower at peak workload (normoxia 3.88 ± 1.19 mmol/l vs. 7.05 ± 2.1 mmol/l; hypoxia 4.01 ± 1.12 mmol/l vs. 7.56 ± 1.82 mmol/l). Qc was diminished but could be increased similar to controls. Fontan patients with higher PA levels showed a higher V . O2peak in hypoxia. CONCLUSION Exercise during short-time artificial altitude exposure seems to be safe for young Fontan patients. Further studies are needed to validate longer exposure under real conditions. V . O2, HR, and Qc might not be a limiting factor for exercise until workloads of 2 W/kg. Higher daily PA levels might improve physical capacity under altitude conditions.
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Affiliation(s)
- Nicole Müller
- Department for Pediatric Cardiology, Children's Hospital, University of Bonn, Bonn, Germany
| | - Ulrike Herberg
- Department for Pediatric Cardiology, Children's Hospital, University of Bonn, Bonn, Germany
| | - Thomas Jung
- Department for Pediatric Cardiology, Children's Hospital, University of Bonn, Bonn, Germany
| | - Johannes Breuer
- Department for Pediatric Cardiology, Children's Hospital, University of Bonn, Bonn, Germany
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Legendre A, Moatemri F, Kovalska O, Balice-Pasquinelli M, Blanchard JC, Lamar-Tanguy A, Ledru F, Cristofini P, Iliou MC. Responses to exercise training in patients with heart failure. Analysis by oxygen transport steps. Int J Cardiol 2021; 330:120-127. [PMID: 33571565 DOI: 10.1016/j.ijcard.2021.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 01/09/2021] [Accepted: 02/03/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Exercise training (ET) increases exercise tolerance, improves quality of life and likely the prognosis in heart failure patients with reduced ejection fraction (HFrEF). However, some patients do not improve, whereas exercise training response is still poorly understood. Measurement of cardiac output during cardiopulmonary exercise test might allow ET response assessment according to the different steps of oxygen transport. METHODS Fifty-three patients with HFrEF (24 with ischemic cardiomyopathy (ICM) and 29 with dilated cardiomyopathy (DCM) had an aerobic ET. Before and after ET program, peak oxygen consumption (VO2peak) and cardiac output using thoracic impedancemetry were measured. Oxygen convection (QO2peak) and diffusion (DO2) were calculated using Fick's principle and Fick's simplified law. Patients were considered as responders if the gain was superior to 10%. RESULTS We found 55% VO2peak responders, 62% QO2peak responders and 56% DO2 responders. Four patients did not have any response. None baseline predictive factor for VO2peak response was found. QO2peak response was related to exercise stroke volume (r = 0.84), cardiac power (r = 0.83) and systemic vascular resistance (SVRpeak) (r = -0.42) responses. Cardiac power response was higher in patients with ICM than in those with DCM (p < 0.05). Predictors of QO2peak response were low baseline exercise stroke volume and ICM etiology. Predictors of DO2 response were higher baseline blood creatinine and prolonged training. CONCLUSION The analysis of the response to training in patients with HFrEF according to the different steps of oxygen transport revealed different phenotypes on VO2peak responses, namely responses in either oxygen convection and/or diffusion.
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Affiliation(s)
- Antoine Legendre
- M3C-Necker, Congenital and Pediatric Cardiology, Hôpital Universitaire Necker-Enfants Malades, Paris, France; Adult Congenital Heart Disease Unit, Cardiology Department, Hôpital Européen Georges Pompidou, Centre de référence des Malformations Cardiaques Congénitales Complexes, M3C, Assistance Publique-Hôpitaux de Paris, Paris, France..
| | - Feriel Moatemri
- Cardiac Rehabilitation and Secondary Prevention Department, Corentin Celton Hospital, APHP Centre University of Paris, Issy les Moulineaux, France
| | - Oksana Kovalska
- Cardiac Rehabilitation and Secondary Prevention Department, Corentin Celton Hospital, APHP Centre University of Paris, Issy les Moulineaux, France
| | - Maria Balice-Pasquinelli
- Cardiac Rehabilitation and Secondary Prevention Department, Corentin Celton Hospital, APHP Centre University of Paris, Issy les Moulineaux, France
| | - Jean-Christophe Blanchard
- Cardiac Rehabilitation and Secondary Prevention Department, Corentin Celton Hospital, APHP Centre University of Paris, Issy les Moulineaux, France
| | - Aurelia Lamar-Tanguy
- Cardiac Rehabilitation and Secondary Prevention Department, Corentin Celton Hospital, APHP Centre University of Paris, Issy les Moulineaux, France
| | - François Ledru
- Cardiac Rehabilitation and Secondary Prevention Department, Corentin Celton Hospital, APHP Centre University of Paris, Issy les Moulineaux, France
| | - Pascal Cristofini
- Cardiac Rehabilitation and Secondary Prevention Department, Corentin Celton Hospital, APHP Centre University of Paris, Issy les Moulineaux, France
| | - Marie-Christine Iliou
- Cardiac Rehabilitation and Secondary Prevention Department, Corentin Celton Hospital, APHP Centre University of Paris, Issy les Moulineaux, France
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Karsenty C, Khraiche D, Jais JP, Raimondi F, Ladouceur M, Waldmann V, Soulat G, Pontnau F, Bonnet D, Iserin L, Legendre A. Predictors of low exercise cardiac output in patients with severe pulmonic regurgitation. Heart 2020; 107:223-228. [PMID: 33199362 DOI: 10.1136/heartjnl-2020-317550] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 10/14/2020] [Accepted: 10/21/2020] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Chronic pulmonic regurgitation (PR) following repair of congenital heart disease (CHD) impairs right ventricular function that impacts peak exercise cardiac index (pCI). We aimed to estimate in a non-invasive way pCI and peak oxygen consumption (pVO2) and to evaluate predictors of low pCI in patients with significant residual pulmonic regurgitation after CHD repair. METHOD We included 82 patients (median age 19 years (range 10-54 years)) with residual pulmonic regurgitation fraction >40%. All underwent cardiac MRI and cardiopulmonary testing with measurement of pCI by thoracic impedancemetry. Low pCI was defined <7 L/min/m2. RESULTS Low pCI was found in 18/82 patients. Peak indexed stroke volume (pSVi) tended to compensate chronotropic insufficiency only in patients with normal pCI (r=-0.31, p=0.01). Below 20 years of age, only 5/45 patients had low pCI but near-normal (≥6.5 L/min/m2). pVO2 (mL/kg/min) was correlated with pCI (r=0.58, p=0.0002) only in patients aged >20 years. Left ventricular stroke volume in MRI correlated with pSVi only in the group of patients with low pCI (r=0.54, p=0.02). No MRI measurements predicted low pCI. In multivariable analysis, only age predicted a low pCI (OR=1.082, 95% CI 1.035 to 1.131, p=0.001) with continuous increase of risk with age. CONCLUSIONS In patients with severe PR, pVO2 is a partial reflection of pCI. Risk of low pCI increases with age. No resting MRI measurement predicts low haemodynamic response to exercise. Probably more suitable to detect ventricular dysfunction, pCI measurement could be an additional parameter to take into account when considering pulmonic valve replacement.
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Affiliation(s)
- Clément Karsenty
- Unité Médico-Chirurgicale de Cardiologie Congénitale Adulte, Hopital Europeen Georges Pompidou, Paris, Île-de-France, France.,Pediatric and Congenital Cardiology, Children's Hospital, CHU Toulouse, Toulouse, Midi-Pyrénées, France
| | - Diala Khraiche
- Pediatric Cardiology Unit 'centre de référence des malformations cardiaques congénitales complexes-M3C', Necker-Enfants Malades Hospitals, Paris, Île-de-France, France
| | - Jean Philippe Jais
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Paris, Île-de-France, France.,Biostatistics Unit, Necker-Enfants Malades Hospitals, Paris, Île-de-France, France
| | - Francesca Raimondi
- Pediatric Cardiology Unit 'centre de référence des malformations cardiaques congénitales complexes-M3C', Necker-Enfants Malades Hospitals, Paris, Île-de-France, France.,Université de Paris, Paris, France
| | - Magalie Ladouceur
- Unité Médico-Chirurgicale de Cardiologie Congénitale Adulte, Hopital Europeen Georges Pompidou, Paris, Île-de-France, France.,INSERM U970, PARCC, Université Paris 5 Descartes, Paris, Île-de-France, France
| | - Victor Waldmann
- Unité Médico-Chirurgicale de Cardiologie Congénitale Adulte, Hopital Europeen Georges Pompidou, Paris, Île-de-France, France
| | - Gilles Soulat
- INSERM U970, PARCC, Université Paris 5 Descartes, Paris, Île-de-France, France.,Department of Radiology, Hospital European George Pompidou, Paris, Île-de-France, France
| | - Florence Pontnau
- Unité Médico-Chirurgicale de Cardiologie Congénitale Adulte, Hopital Europeen Georges Pompidou, Paris, Île-de-France, France
| | - Damien Bonnet
- Pediatric Cardiology Unit 'centre de référence des malformations cardiaques congénitales complexes-M3C', Necker-Enfants Malades Hospitals, Paris, Île-de-France, France.,Université de Paris, Paris, France
| | - Laurence Iserin
- Unité Médico-Chirurgicale de Cardiologie Congénitale Adulte, Hopital Europeen Georges Pompidou, Paris, Île-de-France, France
| | - Antoine Legendre
- Unité Médico-Chirurgicale de Cardiologie Congénitale Adulte, Hopital Europeen Georges Pompidou, Paris, Île-de-France, France .,Pediatric Cardiology Unit 'centre de référence des malformations cardiaques congénitales complexes-M3C', Necker-Enfants Malades Hospitals, Paris, Île-de-France, France
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Haraldsdottir K, Watson AM, Pegelow DF, Palta M, Tetri LH, Levin T, Brix MD, Centanni RM, Goss KN, Eldridge MM. Blunted cardiac output response to exercise in adolescents born preterm. Eur J Appl Physiol 2020; 120:2547-2554. [DOI: 10.1007/s00421-020-04480-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 08/19/2020] [Indexed: 12/17/2022]
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Guirgis L, Khraiche D, Ladouceur M, Iserin L, Bonnet D, Legendre A. Cardiac performance assessment during cardiopulmonary exercise test can improve the management of children with repaired congenital heart disease. Int J Cardiol 2020; 300:121-126. [DOI: 10.1016/j.ijcard.2019.10.032] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 09/03/2019] [Accepted: 10/18/2019] [Indexed: 11/30/2022]
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Takken T, Evertse A, de Waard F, Spoorenburg M, Kuijpers M, Schroer C, Hulzebos EH. Exercise responses in children and adults with a Fontan circulation at simulated altitude. CONGENIT HEART DIS 2019; 14:1005-1012. [PMID: 31602790 PMCID: PMC7003737 DOI: 10.1111/chd.12850] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 08/30/2019] [Accepted: 09/11/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Traveling to high altitude has become more popular. High-altitude exposure causes hypobaric hypoxia. Exposure to acute high altitude, during air travel or mountain stays, seems to be safe for most patients with congenital heart disorders (CHD). Still, current guidelines for CHD patients express concerns regarding safety of altitude exposure for patients with a Fontan circulation. Therefore, investigating hemodynamic and pulmonary responses of acute high-altitude exposure (±2500 m) at rest and during maximal exercise in patients with Fontan circulation can provide clarity in this dispute and may contribute to improvement of clinical counseling. METHODS Twenty-one Fontan patients with 21 age-matched healthy controls, aged 8-40 years, were enrolled in an observational study. Participants performed two cardiopulmonary exercise tests on a cycle ergometer with breath-by-breath respiratory gas analyses combined with noninvasive impedance cardiac output measurements: one at sea level (±6 m) and one at simulated high altitude (±2500 m), respectively. RESULTS The effect of altitude exposure was different in rest for saturation (-2.3% vs -4.1%) between Fontan patients and healthy controls (P < .05). At peak exercise the effects of high altitude exposure was different on VO2 (-5.1% vs 9.6%) and AvO2 -diff (-0.3% vs -12.8%) between Fontan patients and healthy controls. CONCLUSION Although, acute high-altitude exposure has a detrimental effect on exercise capacity, the impact on pulmonary and hemodynamic responses of high-altitude exposure is comparable between Fontan patients and healthy controls.
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Affiliation(s)
- Tim Takken
- Department of Medical Physiology, Child Development and Exercise Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Alyanne Evertse
- Department of Medical Physiology, Child Development and Exercise Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Fleur de Waard
- Department of Medical Physiology, Child Development and Exercise Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Mandy Spoorenburg
- Department of Medical Physiology, Child Development and Exercise Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Martijn Kuijpers
- Department of Medical Physiology, Child Development and Exercise Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Christian Schroer
- Department of Pediatric Cardiology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands.,Department of Pediatrics, Maxima Medical Center Veldhoven, Veldhoven, the Netherlands
| | - Erik H Hulzebos
- Department of Medical Physiology, Child Development and Exercise Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands
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Amedro P, Gavotto A, Legendre A, Lavastre K, Bredy C, De La Villeon G, Matecki S, Vandenberghe D, Ladeveze M, Bajolle F, Bosser G, Bouvaist H, Brosset P, Cohen L, Cohen S, Corone S, Dauphin C, Dulac Y, Hascoet S, Iriart X, Ladouceur M, Mace L, Neagu OA, Ovaert C, Picot MC, Poirette L, Sidney F, Soullier C, Thambo JB, Combes N, Bonnet D, Guillaumont S. Impact of a centre and home-based cardiac rehabilitation program on the quality of life of teenagers and young adults with congenital heart disease: The QUALI-REHAB study rationale, design and methods. Int J Cardiol 2019; 283:112-118. [DOI: 10.1016/j.ijcard.2018.12.050] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 11/11/2018] [Accepted: 12/17/2018] [Indexed: 11/26/2022]
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Hemodynamic and cardiorespiratory responses to various arm cycling regimens in men with spinal cord injury. Spinal Cord Ser Cases 2019; 5:2. [PMID: 30675386 DOI: 10.1038/s41394-018-0145-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Revised: 12/04/2018] [Accepted: 12/10/2018] [Indexed: 12/13/2022] Open
Abstract
Study design Repeated measures within-subjects crossover study. Objectives High intensity interval exercise (HIIE) elicits higher oxygen consumption (VO2) and heart rate (HR) versus moderate intensity continuous exercise (MICE) in men with spinal cord injury (SCI). No study has compared hemodynamic responses to HIIE versus MICE in SCI. In this study, we determined hemodynamic and cardiorespiratory responses to different bouts of arm cycling in men with SCI. Setting Human Performance Laboratory, San Diego, CA. Methods Five men (age and injury duration = 42.6 ± 16.1 yr and 9.9 ± 7.6 yr) with SCI participated in the study. VO2peak and peak power output were initially assessed. Subsequent visits included MICE, HIIE, sprint interval exercise (SIE), and a no-exercise control (CON). Energy expenditure was matched across modes and equal to 100 ± 10 kcal. During the bouts, cardiac output (CO), stroke volume (SV), HR, and VO2 were measured. Results Heart rate, SV, and CO increased in response to all exercise bouts and were higher during exercise versus CON. During HIIE and SIE, heart rate approached 90% of maximum, and stroke volume increased by 40% which was higher (p < 0.05) versus MICE and CON. In addition, exercise led to a two (MICE) to threefold increase in CO (HIIE and SIE) although it was not different from CON. VO2 during SIE and HIIE was higher (p < 0.05) versus MICE. Conclusions Similar to results in non-disabled populations, HIIE and SIE elicit near-maximal values of SV and CO.
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Latest Advances in Cardiac Output Monitoring from High-Definition Impedance Cardiography. CURRENT ANESTHESIOLOGY REPORTS 2018. [DOI: 10.1007/s40140-018-0271-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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