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Zhu T, Chen Q, Chen H, You L, Liu D, Zhang X, Li F, Wu H, Tang J, Lin D, Sun K, Yan L, Ren M. Independent and interactive associations of heart rate and obesity with type 2 diabetes mellites: A population-based study. J Diabetes 2024; 16:e13529. [PMID: 38599825 PMCID: PMC11006609 DOI: 10.1111/1753-0407.13529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 12/13/2023] [Accepted: 12/25/2023] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Although obesity and heart rate (HR) were closely related to the prevalence and development of type 2 diabetes mllitus (T2DM), few studies have shown a co-association effect of them on T2DM. We aimed at assessing the interactive effects of HR and obesity with prevalence of T2DM in Chinese population, providing the exact cutpoint of the risk threshold for blood glucose with high HR. MATERIALS AND METHODS In the Risk Evaluation of cAncers in Chinese diabeTic Individuals: a lONgitudinal study (REACTION) cohorts (N = 8398), the relationship between HR and T2DM was explored by linear regression, logistic regression, and restricted cubic spline, and odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Interaction terms between HR and body mass index (BMI) and HR and waist circumference (WC) were introduced into the logistic regression model. RESULTS In those with HR > 88.0 beats/min, fasting plasma glucose and oral glucose tolerance tests were significantly correlated with HR, and the prevalence of T2DM was highly correlated with HR (all p < .05). There were interactive associations of HR and obesity in patients with T2DM with HR < 74 beats/min. CONCLUSION High HR was in interaction with obesity, associating with prevalence of T2DM. The newly subdivided risk threshold for HR with T2DM might be HR > 88 beats/minute.
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Affiliation(s)
- Tianxin Zhu
- Department of Endocrinology, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Qingyu Chen
- Health Examination Center, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Hongxing Chen
- Department of Endocrinology, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Lili You
- Department of Endocrinology, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Dan Liu
- Department of Endocrinology, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Xiaoyun Zhang
- Department of Endocrinology, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Feng Li
- Department of Endocrinology, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Hongshi Wu
- Department of Endocrinology, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Juying Tang
- Department of Endocrinology, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Diaozhu Lin
- Department of Endocrinology, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Kan Sun
- Department of Endocrinology, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Li Yan
- Department of Endocrinology, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Meng Ren
- Department of Endocrinology, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
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Fantin A, Patruno V, Sartori G, Crisafulli E. Autonomic nervous system alterations in patients with mild-to-moderate asthma: do not forget airflow obstruction! A lesson from COPD. J Asthma 2022; 60:1054-1055. [PMID: 35972058 DOI: 10.1080/02770903.2022.2114085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Affiliation(s)
- Alberto Fantin
- Department of Pulmonology, S. Maria della Misericordia University Hospital, Udine, Italy
| | - Vincenzo Patruno
- Department of Pulmonology, S. Maria della Misericordia University Hospital, Udine, Italy
| | - Giulia Sartori
- Department of Medicine, Respiratory Medicine Unit, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Ernesto Crisafulli
- Department of Medicine, Respiratory Medicine Unit, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
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Aparisi Á, Ladrón R, Ybarra-Falcón C, Tobar J, San Román JA. Exercise Intolerance in Post-Acute Sequelae of COVID-19 and the Value of Cardiopulmonary Exercise Testing- a Mini-Review. Front Med (Lausanne) 2022; 9:924819. [PMID: 35935782 PMCID: PMC9352932 DOI: 10.3389/fmed.2022.924819] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 06/21/2022] [Indexed: 12/04/2022] Open
Abstract
Coronavirus disease (COVID-19) is an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), with systemic organ damage in the most severe forms. Long-term complications of SARS-CoV-2 appear to be restricted to severe presentations of COVID-19, but many patients with persistent symptoms have never been hospitalized. Post-acute sequelae of COVID-19 (PASC) represents a heterogeneous group of symptoms characterized by cardiovascular, general, respiratory, and neuropsychiatric sequelae. The pace of evidence acquisition with PASC has been rapid, but the mechanisms behind it are complex and not yet fully understood. In particular, exercise intolerance shares some features with other classic respiratory and cardiac disorders. However, cardiopulmonary exercise testing (CPET) provides a comprehensive assessment and can unmask the pathophysiological mechanism behind exercise intolerance in gray-zone PASC. This mini-review explores the utility of CPET and aims to provide a comprehensive assessment of PASC by summarizing the current evidence.
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Affiliation(s)
- Álvaro Aparisi
- Unidad de Cardiología Intervencionista, Servicio de Cardiología, Hospital del Mar, Barcelona, Spain
- Biomedical Research in Heart Diseases (GREC), Instituto Hospital del Mar de Investigaciones Médicas (IMIM), Barcelona, Spain
| | - Raquel Ladrón
- Servicio de Cardiología, Virgen del Rocío, Sevilla, Spain
| | - Cristina Ybarra-Falcón
- Servicio de Cardiología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Javier Tobar
- Servicio de Cardiología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
- Centro de investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
- *Correspondence: Javier Tobar
| | - J. Alberto San Román
- Servicio de Cardiología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
- Centro de investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
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He J, Fu J, Zhao W, Ren C, Liu P, Chen L, Li D, Zhou L, Tang L, Liu X, Ye S, Liu X, Ma Y, Zhang Y, Ma X, Zhang L, Zhang G, Li N, Fan D. Exercise Physiology Impairments of Patients With Amyotrophic Lateral Sclerosis: Cardiopulmonary Exercise Testing Findings. Front Physiol 2022; 13:792660. [PMID: 35370778 PMCID: PMC8967153 DOI: 10.3389/fphys.2022.792660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 02/15/2022] [Indexed: 12/05/2022] Open
Abstract
Background and Objective In amyotrophic lateral sclerosis (ALS), progressive weakness significantly limits the ability to exercise. However, measurements of the impaired exercise function and their practical value to assess disease progression in ALS are scarce. Cardiopulmonary exercise testing (CPET) is a non-invasive accurate method used to comprehensively quantify exercise physiology in a variety of diseases. This study aimed to evaluate the clinical value of CPET and to explore its association with disease severity and prognosis prediction in ALS. Methods A total of 319 participants were enrolled in this 3-year prospective study. After strict quality control, 109 patients with ALS and 150 age- and sex-matched healthy controls were included with comprehensive clinical assessment and follow-ups. The incremental ramp protocol for symptom-limited CPET was applied in both groups. The exercise physiology during peak effort exercise was systematically measured, including the overall aerobic capacity of exercise (VO2 peak) and the respective capacity of the exercise-involved organs [cardiac response (heart rate peak—HR peak), ventilatory efficiency (VE/VCO2 slope), breathing economy (VE/VO2 peak), and other relevant parameters]. Disease severity and progression were evaluated using recognized scales. Survival was monitored with regular follow-ups every 6 months. Results Decreased exercise capacity (VO2 peak < 16 ml/kg/min) occurred more frequently in patients with ALS than in controls (44.95% vs. 9.33%, p < 0.01). In patients with ALS, the average VO2 peak (16.16 ± 5.43 ml/kg/min) and HR peak [135 (112–153) bpm] were significantly lower (p < 0.01) than in controls [22.26 ± 7.09 ml/kg/min; 148 (135–164) bpm], but the VE/VCO2 slope was significantly higher [28.05 (25.03–32.16) vs. 26.72 (24.37–29.58); p = 0.03]. In patients with ALS, the VO2 peak and HR peak were significantly correlated with disease severity and progression scores (p < 0.05). Survival analyses revealed the VO2 peak and HR peak as protective indicators while the VE/VO2 peak as a detrimental indicator for the prognostic prediction in ALS (HR = 0.839, p = 0.001; HR = 0.967, p < 0.001; HR = 1.137, p = 0.028, respectively). Conclusion Our prospective study quantified the significantly decreased exercise capacity in ALS through non-invasive CPET. The impaired VO2 peak and HR peak closely correlated with disease severity and independently predicted a worse prognosis. Our findings identified the clinical value of CPET as an objective indicator of disease progression in ALS.
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Affiliation(s)
- Ji He
- Department of Neurology, Peking University Third Hospital, Beijing, China
- Beijing Municipal Key Laboratory of Biomarker and Translational Research in Neurodegenerative Diseases, Beijing, China
| | - Jiayu Fu
- Department of Neurology, Peking University Third Hospital, Beijing, China
- Beijing Municipal Key Laboratory of Biomarker and Translational Research in Neurodegenerative Diseases, Beijing, China
| | - Wei Zhao
- Department of Cardiology, Peking University Third Hospital, Beijing, China
- Physical Examination Center, Peking University Third Hospital, Beijing, China
| | - Chuan Ren
- Department of Cardiology, Peking University Third Hospital, Beijing, China
- Physical Examination Center, Peking University Third Hospital, Beijing, China
| | - Ping Liu
- Department of Cardiology, Peking University Third Hospital, Beijing, China
- Physical Examination Center, Peking University Third Hospital, Beijing, China
| | - Lu Chen
- Department of Neurology, Peking University Third Hospital, Beijing, China
- Beijing Municipal Key Laboratory of Biomarker and Translational Research in Neurodegenerative Diseases, Beijing, China
| | - Dan Li
- Department of Cardiology, Peking University Third Hospital, Beijing, China
- Physical Examination Center, Peking University Third Hospital, Beijing, China
| | - Lequn Zhou
- Department of Cardiology, Peking University Third Hospital, Beijing, China
| | - Lu Tang
- Department of Neurology, Peking University Third Hospital, Beijing, China
- Beijing Municipal Key Laboratory of Biomarker and Translational Research in Neurodegenerative Diseases, Beijing, China
| | - Xiangyi Liu
- Department of Neurology, Peking University Third Hospital, Beijing, China
- Beijing Municipal Key Laboratory of Biomarker and Translational Research in Neurodegenerative Diseases, Beijing, China
| | - Shan Ye
- Department of Neurology, Peking University Third Hospital, Beijing, China
- Beijing Municipal Key Laboratory of Biomarker and Translational Research in Neurodegenerative Diseases, Beijing, China
| | - Xiaolu Liu
- Department of Neurology, Peking University Third Hospital, Beijing, China
- Beijing Municipal Key Laboratory of Biomarker and Translational Research in Neurodegenerative Diseases, Beijing, China
| | - Yan Ma
- Department of Neurology, Peking University Third Hospital, Beijing, China
- Beijing Municipal Key Laboratory of Biomarker and Translational Research in Neurodegenerative Diseases, Beijing, China
| | - Yixuan Zhang
- Department of Neurology, Peking University Third Hospital, Beijing, China
- Beijing Municipal Key Laboratory of Biomarker and Translational Research in Neurodegenerative Diseases, Beijing, China
| | - Xinran Ma
- Department of Neurology, Peking University Third Hospital, Beijing, China
- Beijing Municipal Key Laboratory of Biomarker and Translational Research in Neurodegenerative Diseases, Beijing, China
| | - Linjing Zhang
- Department of Neurology, Peking University Third Hospital, Beijing, China
- Beijing Municipal Key Laboratory of Biomarker and Translational Research in Neurodegenerative Diseases, Beijing, China
| | - Gaoqi Zhang
- Department of Neurology, Peking University Third Hospital, Beijing, China
- Beijing Municipal Key Laboratory of Biomarker and Translational Research in Neurodegenerative Diseases, Beijing, China
| | - Nan Li
- Clinical Epidemiology Research Center, Peking University Third Hospital, Beijing, China
| | - Dongsheng Fan
- Department of Neurology, Peking University Third Hospital, Beijing, China
- Beijing Municipal Key Laboratory of Biomarker and Translational Research in Neurodegenerative Diseases, Beijing, China
- *Correspondence: Dongsheng Fan,
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Neder JA, Berton DC, Phillips DB, O'Donnell DE. Exertional ventilation/carbon dioxide output relationship in COPD: from physiological mechanisms to clinical applications. Eur Respir Rev 2021; 30:30/161/200190. [PMID: 34526312 PMCID: PMC9489189 DOI: 10.1183/16000617.0190-2020] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 09/30/2020] [Indexed: 01/09/2023] Open
Abstract
There is well established evidence that the minute ventilation (V′E)/carbon dioxide output (V′CO2) relationship is relevant to a number of patient-related outcomes in COPD. In most circumstances, an increased V′E/V′CO2 reflects an enlarged physiological dead space (“wasted” ventilation), although alveolar hyperventilation (largely due to increased chemosensitivity) may play an adjunct role, particularly in patients with coexistent cardiovascular disease. The V′E/V′CO2 nadir, in particular, has been found to be an important predictor of dyspnoea and poor exercise tolerance, even in patients with largely preserved forced expiratory volume in 1 s. As the disease progresses, a high nadir might help to unravel the cause of disproportionate breathlessness. When analysed in association with measurements of dynamic inspiratory constraints, a high V′E/V′CO2 is valuable to ascertain a role for the “lungs” in limiting dyspnoeic patients. Regardless of disease severity, cardiocirculatory (heart failure and pulmonary hypertension) and respiratory (lung fibrosis) comorbidities can further increase V′E/V′CO2. A high V′E/V′CO2 is a predictor of poor outcome in lung resection surgery, adding value to resting lung hyperinflation in predicting all-cause and respiratory mortality across the spectrum of disease severity. Considering its potential usefulness, the V′E/V′CO2 should be valued in the clinical management of patients with COPD. The minute ventilation/carbon dioxide production relationship is relevant to a number of patient-related outcomes in COPD. Minute ventilation/carbon dioxide production, therefore, should be valued in the clinical management of these patients.https://bit.ly/3df2upH
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Affiliation(s)
- J Alberto Neder
- Respiratory Investigation Unit and Laboratory of Clinical Exercise Physiology, Queen's University and Kingston General Hospital, Kingston, ON, Canada
| | - Danilo C Berton
- Respiratory Investigation Unit and Laboratory of Clinical Exercise Physiology, Queen's University and Kingston General Hospital, Kingston, ON, Canada.,Division of Respiratory Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Devin B Phillips
- Respiratory Investigation Unit and Laboratory of Clinical Exercise Physiology, Queen's University and Kingston General Hospital, Kingston, ON, Canada
| | - Denis E O'Donnell
- Respiratory Investigation Unit and Laboratory of Clinical Exercise Physiology, Queen's University and Kingston General Hospital, Kingston, ON, Canada
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Dorelli G, Braggio M, Gabbiani D, Busti F, Caminati M, Senna G, Girelli D, Laveneziana P, Ferrari M, Sartori G, Dalle Carbonare L, Crisafulli E. Importance of Cardiopulmonary Exercise Testing amongst Subjects Recovering from COVID-19. Diagnostics (Basel) 2021; 11:diagnostics11030507. [PMID: 33809260 PMCID: PMC7998697 DOI: 10.3390/diagnostics11030507] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 02/20/2021] [Accepted: 03/11/2021] [Indexed: 11/20/2022] Open
Abstract
The cardiopulmonary exercise test (CPET) provides an objective assessment of ventilatory limitation, related to the exercise minute ventilation (VE) coupled to carbon dioxide output (VCO2) (VE/VCO2); high values of VE/VCO2 slope define an exercise ventilatory inefficiency (EVin). In subjects recovered from hospitalised COVID-19, we explored the methodology of CPET in order to evaluate the presence of cardiopulmonary alterations. Our prospective study (RESPICOVID) has been proposed to evaluate pulmonary damage’s clinical impact in post-COVID subjects. In a subgroup of subjects (RESPICOVID2) without baseline confounders, we performed the CPET. According to the VE/VCO2 slope, subjects were divided into having EVin and exercise ventilatory efficiency (EVef). Data concerning general variables, hospitalisation, lung function, and gas-analysis were also collected. The RESPICOVID2 enrolled 28 subjects, of whom 8 (29%) had EVin. As compared to subjects with EVef, subjects with EVin showed a reduction in heart rate (HR) recovery. VE/VCO2 slope was inversely correlated with HR recovery; this correlation was confirmed in a subgroup of older, non-smoking male subjects, regardless of the presence of arterial hypertension. More than one-fourth of subjects recovered from hospitalised COVID-19 have EVin. The relationship between EVin and HR recovery may represent a novel hallmark of post-COVID cardiopulmonary alterations.
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Affiliation(s)
- Gianluigi Dorelli
- School of Medicine in Sports and Exercise, University of Verona, 37134 Verona, Italy; (G.D.); (M.B.); (M.F.); (L.D.C.)
| | - Michele Braggio
- School of Medicine in Sports and Exercise, University of Verona, 37134 Verona, Italy; (G.D.); (M.B.); (M.F.); (L.D.C.)
| | - Daniele Gabbiani
- Department of Medicine, Section of Internal Medicine, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, 37134 Verona, Italy; (D.G.); (F.B.); (D.G.); (G.S.)
| | - Fabiana Busti
- Department of Medicine, Section of Internal Medicine, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, 37134 Verona, Italy; (D.G.); (F.B.); (D.G.); (G.S.)
| | - Marco Caminati
- Department of Medicine, Allergy and Clinical Immunology Section, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, 37134 Verona, Italy; (M.C.); (G.S.)
| | - Gianenrico Senna
- Department of Medicine, Allergy and Clinical Immunology Section, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, 37134 Verona, Italy; (M.C.); (G.S.)
| | - Domenico Girelli
- Department of Medicine, Section of Internal Medicine, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, 37134 Verona, Italy; (D.G.); (F.B.); (D.G.); (G.S.)
| | - Pierantonio Laveneziana
- INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, AP-HP, Sorbonne Université, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service des Explorations Fonctionnelles de la Respiration, de l’Exercice et de la Dyspnée du Département Médico-Universitaire «APPROCHES», 75013 Paris, France;
| | - Marcello Ferrari
- School of Medicine in Sports and Exercise, University of Verona, 37134 Verona, Italy; (G.D.); (M.B.); (M.F.); (L.D.C.)
| | - Giulia Sartori
- Department of Medicine, Section of Internal Medicine, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, 37134 Verona, Italy; (D.G.); (F.B.); (D.G.); (G.S.)
- Respiratory Medicine Unit, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, 37134 Verona, Italy
| | - Luca Dalle Carbonare
- School of Medicine in Sports and Exercise, University of Verona, 37134 Verona, Italy; (G.D.); (M.B.); (M.F.); (L.D.C.)
- Department of Medicine, Section of Internal Medicine, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, 37134 Verona, Italy; (D.G.); (F.B.); (D.G.); (G.S.)
| | - Ernesto Crisafulli
- Department of Medicine, Section of Internal Medicine, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, 37134 Verona, Italy; (D.G.); (F.B.); (D.G.); (G.S.)
- Respiratory Medicine Unit, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, 37134 Verona, Italy
- Correspondence:
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Abstract
This document reflects the key points of a consensus meeting of the Heart Failure Association of European Society of Cardiology (ESC) held to provide an overview the role of physiological monitoring in the complex multimorbid heart failure (HF) patient. This article reviews assessments of the functional ability of patients with HF. The gold standard measurement of cardiovascular functional capacity is peak oxygen consumption obtained from a cardiopulmonary exercise test. The 6-min walk test provides an indirect measure of cardiovascular functional capacity. Muscular functional capacity is assessed using either a 1−repetition maximum test of the upper and lower body or other methods, such as handgrip measurement. The short physical performance battery may provide a helpful, indirect indication of muscular functional capacity.
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Affiliation(s)
- Massimo F Piepoli
- Heart Failure Unit, Guglielmo da Saliceto Hospital, Cantone del Cristo, 29121 Piacenza, Italy
| | - Ilaria Spoletini
- Department of Medical Sciences, Centre for Clinical and Basic Research, IRCCS San Raffaele Pisana, Rome, Italy
| | - Giuseppe Rosano
- Department of Medical Sciences, Centre for Clinical and Basic Research, IRCCS San Raffaele Pisana, Rome, Italy
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Radtke T, Crook S, Kaltsakas G, Louvaris Z, Berton D, Urquhart DS, Kampouras A, Rabinovich RA, Verges S, Kontopidis D, Boyd J, Tonia T, Langer D, De Brandt J, Goërtz YM, Burtin C, Spruit MA, Braeken DC, Dacha S, Franssen FM, Laveneziana P, Eber E, Troosters T, Neder JA, Puhan MA, Casaburi R, Vogiatzis I, Hebestreit H. ERS statement on standardisation of cardiopulmonary exercise testing in chronic lung diseases. Eur Respir Rev 2019; 28:28/154/180101. [PMID: 31852745 PMCID: PMC9488712 DOI: 10.1183/16000617.0101-2018] [Citation(s) in RCA: 166] [Impact Index Per Article: 33.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 06/16/2019] [Indexed: 11/29/2022] Open
Abstract
The objective of this document was to standardise published cardiopulmonary exercise testing (CPET) protocols for improved interpretation in clinical settings and multicentre research projects. This document: 1) summarises the protocols and procedures used in published studies focusing on incremental CPET in chronic lung conditions; 2) presents standard incremental protocols for CPET on a stationary cycle ergometer and a treadmill; and 3) provides patients' perspectives on CPET obtained through an online survey supported by the European Lung Foundation. We systematically reviewed published studies obtained from EMBASE, Medline, Scopus, Web of Science and the Cochrane Library from inception to January 2017. Of 7914 identified studies, 595 studies with 26 523 subjects were included. The literature supports a test protocol with a resting phase lasting at least 3 min, a 3-min unloaded phase, and an 8- to 12-min incremental phase with work rate increased linearly at least every minute, followed by a recovery phase of at least 2–3 min. Patients responding to the survey (n=295) perceived CPET as highly beneficial for their diagnostic assessment and informed the Task Force consensus. Future research should focus on the individualised estimation of optimal work rate increments across different lung diseases, and the collection of robust normative data. The document facilitates standardisation of conducting, reporting and interpreting cardiopulmonary exercise tests in chronic lung diseases for comparison of reference data, multi-centre studies and assessment of interventional efficacy.http://bit.ly/31SXeB5
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Peterman JE, Grim AP, Kaminsky LA, Whaley MH, Fleenor BS, Harber MP. Methodological considerations for calculating ventilatory efficiency in healthy adults. Eur J Prev Cardiol 2019; 27:1566-1567. [PMID: 31349770 DOI: 10.1177/2047487319865726] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- James E Peterman
- Fisher Institute of Health and Well-Being, Ball State University, USA
| | - Adam P Grim
- Clinical Exercise Physiology Program, Ball State University, USA
| | | | | | | | - Matthew P Harber
- Clinical Exercise Physiology Program, Ball State University, USA
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Wang J, Qiu J, Yi L, Hou Z, Benardot D, Cao W. Effect of sodium bicarbonate ingestion during 6 weeks of HIIT on anaerobic performance of college students. J Int Soc Sports Nutr 2019; 16:18. [PMID: 30987663 PMCID: PMC6466775 DOI: 10.1186/s12970-019-0285-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Accepted: 03/28/2019] [Indexed: 12/19/2022] Open
Abstract
Background Past studies have found that sodium bicarbonate ingestion prior to exercise has a performance-enhancing effect on high-intensity exercise. The aim of this study was to investigate the effects of continuous sodium bicarbonate (NaHCO3) supplementation on anaerobic performance during six weeks of high-intensity interval training (HIIT). Methods Twenty healthy college-age male participants were randomly assigned to either the HCO3− group (SB) or the placebo group (PL), with 10 subjects in each group. Both groups completed 6 weeks (3 days/week) of HIIT with the SB ingesting an orange-flavored solution containing 15 g xylitol and 0.2 g HCO3−/kg body mass during each training day, and PL ingesting a similar beverage that was HCO3−-free. This study separated 6 weeks of training into two stages with different training intensities, with the first 3 weeks at a lower intensity than the second 3 weeks. Blood samples to measure serum HCO3− were obtained 5 min before and 30 min after the following HIIT training sessions: Week 1, training session 1; week 3, training session 3; week 6, training session 3. Three 30s Wingate tests (WAnT) were conducted before, in the middle, and after the training and the supplementation interventions, with peak power, mean power, and fatigue index obtained during WAnT, and blood lactate and heart rate obtained after WAnT. Results Our findings indicate the following: 1) Serum HCO3− level of SB was significantly higher than PL (p < 0.05) both before and after each HIIT; 2) Relative peak power in WAnT was significantly higher in the SB group after 6 weeks (p < 0.01); 3) Lactate clearance rate and the lactate clearance velocity after 10 min of WAnT were both significantly higher in SB in the post-test (p < 0.01); 4) Heart rate recovery rate at 10 min after WAnT in both SB and PL after 6 weeks were significantly improved (p < 0.01 and p < 0.05, respectively), resulting in no difference between groups on these measures. Conclusions These data suggest that supplementation of HCO3− at the level of 0.2 g/kg body mass before HIIT training enhances the effect of HIIT on anaerobic performance, and improves the blood lactate clearance rate and the blood lactate clearance velocity following anaerobic exercise.
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Affiliation(s)
- Jieting Wang
- College of Kinesiology, Beijing Sport University, Beijing, BJ, China
| | - Junqiang Qiu
- College of Kinesiology, Beijing Sport University, Beijing, BJ, China.
| | - Longyan Yi
- College of Kinesiology, Beijing Sport University, Beijing, BJ, China
| | - Zhaoran Hou
- College of Kinesiology, Beijing Sport University, Beijing, BJ, China
| | - Dan Benardot
- Department of Nutrition, Georgia State University, Atlanta, GA, USA.,Center for the Study of Human Health, Emory University, Atlanta, GA, USA
| | - Wei Cao
- College of Kinesiology, Beijing Sport University, Beijing, BJ, China
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