Increased Ventilatory Efficiency in Supramaximal Compared to Graded Exercise in Athletes.

: Supramaximal constant work rate tests (CWR) elicit intense hyperventilation, thus potentially up-shifting ventilation (⩒)-to-carbon dioxide (CO) responses when compared to graded exercise tests (GXT) in athletes. We predicted higher ventilatory efficiency on supramaximal CWR using a new method, challenging the classic orthodox interpretation of an increased ⩒-⩒CO as ventilatory inefficiency. This misinterpretation could make difficult to differentiate between physiological hyperventilation from heart disease conditions in athletes.

Ventilatory efficiency (η⩒E) of the exercise: A detailed method report.

Ventilatory efficiency is a combination of the ventilatory-metabolic response stemming from non-invasive analysis of cardiopulmonary exercise testing. Despite being a recognized marker in exercise physiology, this measure presents considerable limitations, including the imprecise designation of "efficiency", broadly recognized, and recently denominated as "excess ventilation". Herein we present a detailed method, with substantial improvements, and new physiological insights, in order to better define the true ventilatory efficiency of the exercise, according to recommendations for physical/physiological processes.

Carotid-body modulation through meditation in stage-I hypertensive subjects: Study protocol of a randomized and controlled study.

Adjunctive therapy for hypertension is in high demand for clinical research. Therefore, several meta-analyses have provided sufficient evidence for meditation as an adjunct therapy, without being anchored on reliable physiological grounds. Meditation modulates the autonomic nervous system.

Pulmonary function and medication effect in mild-stage subjects with Parkinson's disease.

Background: Parkinson's disease (PD) causes a series of movement disorders, many of them starting in the early stage.

Objective: To analyze the pulmonary function of mild-stage subjects with PD and to investigate the effects of levodopa on it.

Methods: We included 21 patients with idiopathic PD and 20 healthy control subjects.

A new ventilatory efficiency index and accuracy for early lung diffusion impairment in non-COPD smokers.

In smokers without manifest airway obstruction, early emphysema and endothelial dysfunction has been related to minute-ventilation/carbon dioxide output ratio (V'/V'CO). Thus, smokers with reduced lung carbon monoxide diffusion capacity (D) have a heightened V'/V'CO ratio. We hypothesized that ventilatory inefficiency could contribute to the suspicion of impaired diffusive capacity in the absence of significant airway obstruction.

Vitamin B Supplementation and NT-proBNP Levels in COPD Patients: A Secondary Analysis of a Randomized and Controlled Study in Rehabilitation.

Purpose: There is evidence of complex interaction between vitamin B (vB) level, hyperhomocysteinemia (HyCy), and natriuretic peptide secretion. Exercise training could also modulate such interaction. In this secondary analysis of a Randomized Clinical Trial performed in a chronic obstructive pulmonary disease (COPD) rehabilitation setting, our primary objective was to investigate the interaction between vB supplementation, exercise training, and changes in NT-proBNP levels after 8 weeks of intervention.

Inspiratory Muscle Training Potentiates the Beneficial Effects of Proportional Assisted Ventilation on Exertional Dyspnea and Exercise Tolerance in COPD: A Proof-of-Concept Randomized and Controlled Trial.

During pulmonary rehabilitation, a subset of subjects with COPD requires adjunct therapy to achieve high-intensity training. Both noninvasive ventilation (NIV) and inspiratory muscle training (IMT) are available to assist these subjects. We aimed to prime the respiratory muscles before NIV with IMT, anticipating additive effects for maximal exercise tolerance () and dyspnea/leg fatigue relief throughout the exercise as primary outcomes.

Cardiopulmonary and Muscular Interactions: Potential Implications for Exercise (In)tolerance in Symptomatic Smokers Without Chronic Obstructive Pulmonary Disease.

Smoking and physical inactivity are important preventable causes of disability and early death worldwide. Reduced exercise tolerance has been described in smokers, even in those who do not fulfill the extant physiological criteria for chronic obstructive pulmonary disease (COPD) and are not particularly sedentary. In this context, it is widely accepted that exercise capacity depends on complex cardio-pulmonary interactions which support oxygen (O) delivery to muscle mitochondria.

Faster oxygen uptake, heart rate, and ventilatory kinetics in stepping compared with cycle ergometry in patients with COPD during moderate-intensity exercise.

Step tests are a stressful and feasible cost-effective modality to evaluate aerobic performance. However, the eccentric in addition to concentric muscle contractions of the legs on stepping emerge as a potential speeding factor for cardioventilatory and metabolic adjustments towards a steady-state, since eccentric contractions would prompt an earlier and stronger mechanoreceptor activation, as well as higher heart rate/cardiac output adjustments to the same metabolic demand. Moreover, shorter tests are ideal for exercise-limited subjects.

Is Inspiratory Muscle Weakness a Determinant of Endurance Exercise Tolerance During NIV-Supported Exercise in Patients With COPD?

Purpose: Previous research has reported that inspiratory muscle weakness is critical to decreased exercise tolerance and exercise tolerance improves with 10 cmH2O pressure support ventilation in patients with chronic obstructive pulmonary disease (COPD). The purpose of this study was to evaluate the effects of proportional assist ventilation (PAV) and continuous positive airway pressure (CPAP) compared with sham on exercise tolerance in patients with and without inspiratory muscle weakness.

Methods: In a prospective design, 12 of 54 patients were eligible after clinical and comprehensive lung function evaluation, including maximum inspiratory pressure (MIP) measurement.

CPAP and EPAP elicit similar lung deflation in a non-equivalent mode in GOLD 3-4 COPD patients.

Introduction: Lung hyperinflation is associated with inspiratory muscle strength reduction, nocturnal desaturation, dyspnea, altered cardiac function and poor exercise capacity in advanced COPD.

Objectives: We investigated the responses of inspiratory capacity (IC) and inspiratory muscle strength (PImax), comparing continuous positive airway pressure (CPAP) and expiratory positive airway pressure (EPAP) with the main hypothesis that there would be similar effects on lung deflation.

Methods: Eligible patients were submitted to 10 cmH O CPAP and EPAP on different days, under careful ECG (HR) and peripheral oxygen saturation (SpO ) monitoring.

Ventilatory Inefficiency and Exertional Dyspnea in Early Chronic Obstructive Pulmonary Disease.

Exertional dyspnea is present across the spectrum of chronic obstructive pulmonary disease (COPD) severity. However, without realizing it themselves, patients may decrease daily physical activity to avoid distressing respiratory sensations. Dyspnea also may be associated with deconditioning.

Addition of vitamin B12 to exercise training improves cycle ergometer endurance in advanced COPD patients: A randomized and controlled study.

Vitamin B12 is essential in the homocysteine, mitochondrial, muscle and hematopoietic metabolisms, and its effects on exercise tolerance and kinetics adjustments of oxygen consumption (V'O) in rest-to-exercise transition in COPD patients are unknown. This randomized, double-blind, controlled study aimed to verify a possible interaction between vitamin B12 supplementation and these outcomes. After recruiting 69 patients, 35 subjects with moderate-to-severe COPD were eligible and 32 patients concluded the study, divided into four groups (n = 8 for each group): 1.

Lung function and left ventricular hypertrophy in morbidly obese candidates for bariatric surgery.

Objective: To look for correlations between lung function and cardiac dimension variables in morbidly obese patients, in order to test the hypothesis that the relative size of the small airways is independently correlated with left ventricular hypertrophy.

Methods: This was a retrospective study involving 192 medical records containing a clinical protocol employed in candidates for bariatric surgery between January of 2006 and December of 2010.

Results: Of the 192 patients evaluated, 39 (10 males and 29 females) met the inclusion criteria.

Reliability of peak O2 uptake and O2 uptake kinetics in step exercise tests in healthy subjects.

To date little is known about the reliability of peak oxygen consumption (V˙O2PEAK) in incremental metronome paced step tests (IST) and the reliability of on-kinetics V˙O2 has never been studied. We aimed to study the reliability of both tests. Eleven healthy subjects performed two ISTs until exhaustion.