Search Results (206)

Background/Objectives: The pathophysiological background of the processes activated by physical activity in patients with heart failure (HF) is not fully understood. Proteomic studies can help to preliminarily identify new protein markers for unknown or poorly defined physiological processes. We aimed to analyse the changes in the plasma proteomic profile of HF patients after a cardiopulmonary exercise test (CPET) to define pathways involved in the response to exercise. Methods: The study prospectively enrolled 20 male patients with advanced HF (aged 53.3 ± 8.3 years). Blood samples were taken from the patients before and immediately after the CPET to obtain plasma proteomic profiles. Two-sample t-tests (paired or non-paired) were performed with and without false discovery rate (FDR) correction for multiple testing. Enrichment analysis was performed to associate biological processes and pathways with the study results. Results: A total of 968 plasma proteins were identified, of which 722 underwent further statistical analysis. Of these, 236 proteins showed differential expression when comparing all plasma samples collected before and after CPT (p < 0.05), and for 86 of these the difference remained statistically significant after FDR correction. Proteins whose expression changed after exercise are mostly involved in immune response and inflammatory processes, coagulation, cell adhesion, regulation of cellular response to stimulus and regulation of programmed cell death. There were no differences in resting proteomics according to HF etiology (ischemic vs. non-ischemic). Conclusions: Changes in the proteomic profile revealed a complexity of exercise-induced processes in patients with HF, suggesting that few major physiological pathways are involved. Further studies focusing on specific pathways are needed. Full article

Aim: (I) to verify if there are sex differences in respiratory function, respiratory muscle strength, and effort limitation in individuals recovered from severe acute COVID-19 30 months after the initial infection, and (II) to evaluate the influence of length of stay on cardiorespiratory capacity among men and women. Methods: Cross-sectional observational multicentric study with participants from five Brazilian states (São Paulo, Amazonas, Minas Gerais, Bahia, and Brasília). We assessed lung function and respiratory muscle strength by maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), and cardiorespiratory fitness by cardiopulmonary exercise test (CPET). Results: 86 individuals were stratified by sex (48 women and 38 men). Females had significantly longer hospitalization for acute COVID-19 (p < 0.05) and showed a marked reduction in MIP (cmH₂O and % predicted). Regarding the CPET, women presented lower V˙O₂% predicted, O₂ pulse, and oxygen uptake efficiency slope (OUES, % predicted) (p < 0.05). In addition, women also had greater abnormal combinations between RER < 1.10, OUES < 80% predicted, VE/VVM < 15% [3 (6.2%)] and V˙O₂% predicted < 80%, V˙E/V˙CO₂ slope and V˙O₂/workload < 8.4 mL/min/W [8 (17%)]. The regression analysis showed a significant influence of age, length of hospitalization (< and >10 days), and FEV₁/FVC (%) on the V˙O₂ peak (mL·kg⁻¹·min⁻¹). Secondarily, we found that women hospitalized for more than 10 days had worse O₂ pulse (p = 0.03), OUES % predicted (p < 0.001), and worse V˙O₂% predicted (p < 0.009). Conclusion: Women exhibited more pronounced impairments in several key indicators of cardiopulmonary function 30 months post-infection. Full article

Background: A knee injury in an athlete leads to periods of forced exercise interruption. Myocardial work (MW) assessed by echocardiographic and cardiopulmonary exercise testing (CPET) are two essential methods for evaluating athletes during the period following injury. However, compared to pre-surgery evaluations, the variations in cardiovascular parameters and functional capacity assessed by these methods after surgery remain unclear. Methods: We evaluated 22 non-professional athletes aged 18–52, involved in prevalently aerobic or alternate aerobic/anaerobic sports activities, who were affected by a knee pathology requiring surgical treatment. The evaluation was performed at rest using transthoracic echocardiography, including MW assessment, and during exercise using CPET. Each athlete underwent the following two evaluations: the first before surgery and the second after surgery (specifically at the end of the deconditioning period). Results: Resting heart rate (HR) increased significantly (from 63.3 ± 10.85 to 71.2 ± 12.52 beats per minute, p = 0.041), while resting diastolic and systolic blood pressure, forced vital capacity, and forced expiratory volume in the first second did not show significant changes. Regarding the echocardiographic data, global longitudinal strain decreased from −18.9 ± 1.8 to −19.3 ± 1.75; however, this reduction was not statistically significant (p = 0.161). However, the global work efficiency (GWE) increased significantly (from 93.0% ± 2.9 to 94.8% ± 2.6, p = 0.006) and global wasted work (GWW) reduced significantly (from 141.4 ± 74.07 to 98.0 ± 50.9, p = 0.007). Additionally, the patients were able to perform maximal CPET at both pre- and post-surgery evaluations, as demonstrated by the peak respiratory exchange ratio and HR. However, the improved myocardial contractility (increased GWE and decreased GWW) observed at rest did not translate into significant changes in exercise parameters, such as peak oxygen consumption and the mean ventilation/carbon dioxide slope. Conclusions: After surgery, the athletes were more deconditioned (as indicated by a higher resting HR) but exhibited better resting myocardial contractility (increased GWE and reduced GWW). Interestingly, no significant changes in exercise capacity parameters, as evaluated by CPET, were found after surgery, suggesting that the improved myocardial contractility was offset by a greater degree of muscular deconditioning. Full article

Respiratory muscle training (RMT) improves endurance performance, balance, and ability to repeat high-intensity exercise bouts, providing a rationale to be applied in short-track speedskating. To establish a preferable RMT method for short-track speedskating, the influence of inspiratory pressure threshold loading (IPTL) and voluntary isocapnic hyperpnoea (VIH) on cardiopulmonary indices and athletic performance was investigated. Sixteen elite short-track speedskaters completed 6 weeks of RMT based on IPTL or VIH. Wingate Anaerobic Tests (WAnTs), cardiopulmonary exercise tests (CPETs), spirometry assessments, and on-ice time trials were performed before and after RMT intervention. Repeated measures ANOVA was used to assess the differences between each method’s influence. No statistically significant (p > 0.05) differences between RMT methods were found in performance during the WAnT, CPET, or specific on-ice time trials. Spirometry measures were similar between both methods. Significant effects were found for the interaction between maximum breathing frequency during CPET (BFmax) and method (p = 0.009), as well as for the interaction between BFMax, method, and sex (p = 0.040). BFmax decreased for IPTL and increased for VIH. The interaction between method and sex revealed that BFmax increased only in males performing VIH. Our findings suggest that IPTL and VIH lead to analogous effects in the study participants, highlighting a negligible practical disparity in the impact of different RMT methods in elite short-track speedskaters. Full article

Background: Preserving health and physical fitness is critical to ensure independent living across the lifespan. Lower levels of physical fitness are associated with age-related cognitive decline and a higher prevalence of mild cognitive impairment (MCI). Thus, this study investigates the influence of a six-month dance intervention on selected measures of physical fitness in older adults with MCI. Methods: In this randomized controlled trial, 55 patients with MCI were randomized into a sportive dance training (IG; n = 26; age: 70.7 ± 5.6 years; 62% female) or an inactive control group (CG; n = 24; age: 69.1 ± 6.8 years; 46% female). The dance group received two 90 min dance training sessions per week over a duration of six-months, which focused on learning dance movement patterns. During the training sessions, heart rate was measured to control exercise intensity. Physical fitness was assessed using cardiopulmonary exercise testing (CPET), lower limb functional fitness via sit-to-stand test, handgrip strength, and heart rate variability (HRV). Results: We observed that the dance intervention preserved the cardiorespiratory fitness as measured by maximal oxygen uptake (VO_2max) during CPET, which decreased in the CG. Furthermore, participants in the IG demonstrated increases in leg and handgrip strength, although these were not statistically significant. HRV displayed a non-significant decrease following the intervention. Conclusions: The results of this randomized controlled trial suggest that sportive dance training can preserve elements of physical fitness (i.e., cardiorespiratory fitness) in older adults with MCI. Although improvements in the other parameters (i.e., leg and handgrip strength) were statistically non-significant, likely due to the small sample size, stabilizing muscular fitness and preventing age-related decline in older adults with MCI is important for maintaining functional independence. For future studies, we recommend a longer training duration paired with precise control of regular physical activity levels, an important confounding factor. Full article

Cathodic plasma electrolytic treatment (CPET) is an emerging surface modification and coating preparation technology. By utilizing plasma discharge induced through electrolysis and the cooling impact of electrolyte, metal cleaning, saturation, and coating preparation are efficiently achieved. In this review, the principle, application, and development of the CPET process are briefly summarized based on the past literature. Detailed insights are provided into the influence of electrolyte parameters (pH, metal salt concentration, and temperature), electrical parameters (voltage, duty cycle, and frequency), and process parameters (electrode area ratio, material, roughness, and deposition time) on plasma discharge and coating formation for metal coatings. The interaction mechanism between plasma and material surfaces is also investigated. Recommendations and future research avenues are suggested to propel CPET and its practical implementations. This review is expected to provide assistance and inspiration for researchers engaged in CPET. Full article

Background: The aim of this study was to examine the effect of applying synchronized music and appropriate music selection on motivation for exercise and achieving better results in individuals of different fitness levels. Methods: The study included a total of 20 female participants, who for certain analyses were divided into two groups with slightly different levels of aerobic fitness: students from the Faculty of Sport and Physical Education (n = 10, age 23.0 ± 2.8), and middle-aged adult women exercising recreationally (n = 10, age 38.3 ± 11.6). Cardiopulmonary exercise testing (CPET) was conducted using a treadmill and gas analysis equipment, and motivational music qualities were assessed using the BMRI-2 questionnaire. The procedure included an initial maximal CPET test, echocardiography, and spirometric tests, followed by an interview to select preferred music tracks. A second CPET test was then performed with the chosen motivational music. The Borg Rating of Perceived Exertion (RPE) scale was used in both tests. Results: The internal consistency of the questionnaire was confirmed with a Cronbach’s Alpha of 0.982. The synchronized motivational music significantly improved cardiopulmonary parameters such as peak oxygen consumption (peak VO₂), oxygen consumption (VO₂) at the second ventilatory threshold (VT2), peak heart rate (peak HR), test duration, and reduced perceived exertion (RPE) at the beginning of the test and at the intensity level corresponding to the VT2. Negligible differences were noted between students and recreational athletes, so it can be assumed that music had an equal impact on these two groups of subjects. Conclusions: The study concluded that synchronous motivational music significantly enhances cardiopulmonary performance and reduces perceived fatigue during physical exertion by serving as a key motivational element and facilitating more economical movement. Full article

Chest deformities in children with scoliosis may result in cardiopulmonary disorders, lowering cardiopulmonary capacity levels. However, results regarding the dependence of cardiopulmonary capacity on the severity level of scoliosis remain controversial. We aimed to use dynamic cardiopulmonary exercise testing (CPET) to investigate exercise capacity in reference to spinal deformity in patients with mild or moderate idiopathic scoliosis by means of multivariate analyses. Methods: We included 92 children and adolescents aged 10–17 years with mild and moderate idiopathic scoliosis and 94 healthy peers. The study consisted of three parts: (1) medical record analyses; (2) anthropometric measurements; and (3) CPET. Results: Our results revealed that the mean VO_2peak and VO_2peak/kg values of the participants with scoliosis were 0.27 L/min and 0.37 mL/min/kg lower than their healthy peers, respectively, regardless of age and gender. Furthermore, the occurrence of scoliosis correlates with a mean decrease in minute ventilation volume by 10.10 L/min, tidal volume by 0.11 L, breathing frequency by 3.78 bpm, and breathing reserve by 14.34%, regardless of the age and gender of the participants. Children and adolescents with mild-to-moderate scoliosis during CPET exhibit a lower ventilation capacity and lower VO₂ max than healthy adolescents matched in age but their cardiorespiratory fitness parameters do not depend on the Cobb angle value and the angle rotation of the primary spinal curvature. Conclusions: Physical therapy and activity should be recommended to prevent cardiorespiratory failure in later life in patients with scoliosis. This study may also provide CPET reference values for healthy children and adolescents with scoliosis. Full article

Facioscapulohumeral dystrophy (FSHD) leads to progressive changes in body composition such as loss of muscle mass and increase in adiposity. In healthy subjects, anthropometric parameters are associated with the maximum volume of oxygen consumed per minute (VO₂max), which is a health and function indicator in several populations of subjects, both healthy and pathological. Since VO₂max can be difficult to test in patients with FSHD due to exercise intolerance, the identification of associated anthropometric parameters could provide new easily obtainable elements for the patients’ clinical stratification. The aim of this study was to evaluate whether anthropometric and body composition parameters are associated with VO₂max in patients with FSHD. A total of 22 subjects with a molecular genetics-based diagnosis of FSHD (6 females, 16 males, mean age of 35.18 years) were recruited for the study. VO₂max was measured by cardiopulmonary exercise tests (CPETs) on a cycle ergometer, utilizing a step incremental technique (15 Watts (W) every 30 s). Weight (Kg) and height (m) were obtained and utilized to calculate body mass index (BMI). Body composition parameters (fat mass (FM), fat free mass (FFM), and body cell mass (BCM)) were obtained by bioelectrical impedance analysis (BIA). Significant negative associations were found between VO₂max and FM (Spearman correlation coefficient (SCC) −0.712), BMI (SCC −0.673), age (SCC −0.480), and weight (SCC −0.634), unlike FFM and BCM. Our results indicate that FM, BMI, age, and body weight are negatively associated with VO₂max in patients with FSHD. This evidence may help practitioners to better stratify patients with FSHD. Full article

Background/Objectives: Cardiorespiratory complications are commonly reported among patients with long COVID-19 syndrome. However, their effects on exercise capacity remain inconclusive. We investigated the impact of long COVID-19 on exercise tolerance combining cardiopulmonary exercise testing (CPET) with resting echocardiographic data. Methods: Forty-two patients (55 ± 13 years), 149 ± 92 days post-hospital discharge, and ten healthy age-matched participants underwent resting echocardiography and an incremental CPET to the limit of tolerance. Left ventricular global longitudinal strain (LV-GLS) and the left ventricular ejection fraction (LVEF) were calculated to assess left ventricular systolic function. The E/e’ ratio was estimated as a surrogate of left ventricular end-diastolic filling pressures. Tricuspid annular systolic velocity (SRV) was used to assess right ventricular systolic performance. Through tricuspid regurgitation velocity and inferior vena cava diameter, end-respiratory variations in systolic pulmonary artery pressure (PASP) were estimated. Peak work rate (WRpeak) and peak oxygen uptake (VO₂peak) were measured via a ramp incremental symptom-limited CPET. Results: Compared to healthy participants, patients had a significantly (p < 0.05) lower LVEF (59 ± 4% versus 49 ± 5%) and greater left ventricular end-diastolic diameter (48 ± 2 versus 54 ± 5 cm). In patients, there was a significant association of E/e’ with WRpeak (r = −0.325) and VO₂peak (r = −0.341). SRV was significantly associated with WRpeak (r = 0.432) and VO₂peak (r = 0.556). LV-GLS and PASP were significantly correlated with VO₂peak (r = −0.358 and r = −0.345, respectively). Conclusions: In patients with long COVID-19 syndrome, exercise intolerance is associated with left ventricular diastolic performance, left ventricular end-diastolic pressure, PASP and SRV. These findings highlight the interrelationship of exercise intolerance with left and right ventricular performance in long COVID-19 syndrome. Full article

This study investigates the application of microwave combined induction heating (MCIH) to steam ready-to-eat pork with rice powder, emphasizing the advantages of rapid and uniform heating. The experimental setup included a mixture of 180 g pork strips, 30 g rice powder, and 10 g water in a CPET tray using MCIH with 1080 W microwave (MW) and 130 °C induction heating (IH) for 150 s. The results showed a quick temperature increase rate of 0.56 °C/s that achieved pasteurization against a variety of pathogenic bacteria, such as Listeria monocytogenes, but not Clostridium botulinum, by lethality calculation. Compared to typical electric cooker steaming, MCIH significantly shortened cooking time (8.6 times faster). To address rice starch gelatinization, two-stage heating techniques to steam pork with rice powder were MCIH: 150 s, and then IH: 60 s (MW1), and MCIH: 180 s, and then IH: 30 s (MW2), with no significant differences seen in color or the nine-point taste scale between treatment groups. MCIH groups had smaller shear forces than control. After MCIH cooking, no microbial counts were detected in the MW1 and MW2 groups initially, and the pork with rice powder had a shelf life of 14 days at 4 °C based on aerobic plate count assay. Full article

Background and Objectives: Obstructive sleep apnea (OSA) is common in cardiovascular disease (CVD), although positive airway pressure (PAP) treatment has not been demonstrated to improve the cardiovascular outcome. The objective of this study is to investigate the impact of adherence to PAP therapy on cardiopulmonary exercise testing (CPET) performance in patients with concomitant OSA and CVD. Materials and Methods: This preliminary study involved symptomatic OSA patients requiring PAP treatment who had CVD. All subjects underwent polysomnography, echocardiography, and CPET at baseline. After 6 to 12 months of PAP treatment, CPET performance was re-assessed. The changes in CPET parameters before and after PAP treatment were compared between patients who were adherent to PAP and patients who were not adherent to PAP. Results: A total of 16 OSA patients with an apnea–hypopnea index of 32.0 ± 23.4 were enrolled. Patients were classified into the adherent (n = 9) and non-adherent (n = 7) groups with regard to PAP adherence. After 6 to 12 months of PAP treatment, the PAP-adherent group showed a greater increase in peak VO2 than the PAP-non-adherent group, but the difference between the two groups was not significant (p = 0.581). The decrease in ventilatory equivalent for the carbon dioxide slope (VE/VCO2) was significantly greater in the PAP-adherent group compared to the PAP-non-adherent group (p = 0.030). Conclusions: Adherence to PAP therapy for OSA is associated with an improvement in the VE/VCO2 slope, as an index of the ventilatory response to exercise, in patients with CVD. Screening for sleep apnea in CVD patients may be warranted, and strategies to optimize adherence to PAP in these patients are beneficial. Further evidence is needed to elucidate whether CPET could be routinely used to monitor treatment responses of OSA to PAP therapy in patients with CVD. Full article

Background and Objectives: In adults, 150 to 300 min a week of moderate-intensity physical activity is the recommended daily level to maintain or improve fitness. In subjects with chronic obstructive pulmonary disease (COPD), reductions in daily physical activity (DPA) amounts are related to clinically significant outcomes. In this study, we ascertain whether or not COPD patients, when clustered into active (DPA ≥ 30 min a day, 5 days a week) and inactive (DPA < 30 min a day, 5 days a week), may differ in exercise capacity, as assessed by a cardiopulmonary exercise test (CPET). Materials and Methods: A large sample of clinically stable COPD patients was retrospectively recruited and then underwent spirometry and an incremental ramp protocol 5–15 watts/min CPET. DPA was assessed by a questionnaire. Results: A total of 83 (female 25%, age range 41–85 y) active and 131 (female 31%, age range 49–83 y) inactive participants were enrolled. They were similar in age, sex distribution, body mass index (BMI) and in spirometry. The two groups were significantly different in dyspnea on exertion, as assessed by the modified Medical Research Council (mMRC), and in cardio-metabolic parameters, but not in ventilatory ones, as confirmed by the CPET. Conclusions: COPD patients experiencing physical activity of at least 30 min a day, 5 days a week, showed a greater exercise capacity and an improved cardiovascular response to exercise, when compared to inactive ones. Active and inactive participants did not differ in terms of airflow obstruction severity as well as in dynamic hyperinflation and ventilatory inefficiency during exercise. This study further suggests the benefits of regular physical activity in COPD. Full article

Background: The purpose of this investigation was to determine the elastic characteristics of the common carotid artery (CCA) during endurance exercise at 3 different intensities. Methods: Twenty young healthy participants (10 males and 10 females) participated in this quasi-experimental cross-sectional study. Participants were tested in two sessions: (1) we took resting measurements of the elastic characteristics of the CCA and performed a cardiopulmonary exercise test (CPET) on a cycle ergometer to determine submaximal exercise intensities, and we conducted (2) measurements of the elastic characteristics of the CCA while exercising in a cycle ergometer at 3 intensities based on blood lactate levels of low (<2 mmol/L), moderate (2–4 mmol/L), and high (>4 mmol/L). Beta stiffness was calculated using CCA diameters during systole and diastole, measured with high-definition ultrasound imaging, and CCA systolic and diastolic pressures were measured via applanation tonometry. Results: Overall, there were no differences between males and females in terms of any of the studied variables (p > 0.05). In addition, no significant changes were found in the CCA beta stiffness and vessel diameter (p > 0.05) between exercise intensities. There was a significant exercise intensity effect on CCA systolic pressure (p < 0.05), but not on CCA diastolic pressure (p > 0.05). Conclusions: The biomechanical characteristics of the CCA, determined via compliance and beta-stiffness, do not change during cyclical aerobic exercise, regardless of exercise intensity. Full article

Background and Objectives: The aim of the study was to evaluate the health status of professional athletes after recovering from COVID-19 and the impact that SARS-CoV-2 had on their overall cardiorespiratory fitness, which was done by conducting cardiopulmonary exercise testing (CPET). Materials and Methods: A total of twenty-seven professional basketball players (Euroleague Basketball and the ABA League) participated in the study. CPET was performed before (as part of their regular preparticipation exam, during the pre-season period), as well as after SARS-CoV-2 infection (after two weeks of home isolation, during the competitive part of the season). CPET was performed on a treadmill, while cardiovascular, respiratory, and metabolic functions were evaluated by using a breath-by-breath analysis technique (Quark CPET system manufactured by Cosmed, Rome, Italy). Results: Maximal oxygen consumption and aerobic efficiency were significantly reduced after SARS-CoV-2 infection (p = 0.000). An obvious decrease in oxygen pulse was observed during CPET after recovering from COVID-19 (p = 0.001), as was deterioration of ventilatory efficiency. Internal respiration was the most negatively affected. An early transition from aerobic to anaerobic mechanisms of creating energy for work and intensive metabolic fatigue were obvious after SARS-CoV-2 infection. Conclusions: Although it was believed that SARS-CoV-2 only affects the cardiopulmonary status of the elderly population and people with associated comorbidities, it is clear from this research that professional athletes can also be at certain risk. Even though no pathological cardiovascular and respiratory changes were found in athletes after COVID-19, results showed significantly decreased cardiorespiratory fitness, with an emphasis on internal respiration. Full article