Introduction: An adequate level of cardiorespiratory fitness (CRF) is critical for firefighters to perform the strenuous and physiologically demanding work of firefighting safely and effectively. The coronavirus disease 2019 (COVID-19) has been shown to negatively impact CRF in both the acute phase and longer-term following infection. This study aimed to determine changes to the CRF of firefighters pre- to post-mild to moderate COVID-19 infection and to investigate the impact of days past COVID-19 infection on change in CRF.
View Article and Find Full Text PDFPurpose Of Review: Cardiopulmonary exercise testing (CPET) is the gold standard for directly assessing cardiorespiratory fitness (CRF) and has a relatively new and evolving role in evaluating atherosclerotic heart disease, particularly in detecting cardiac dysfunction caused by ischemic heart disease. The purpose of this review is to assess the current literature on the link between cardiovascular (CV) risk factors, cardiac dysfunction and CRF assessed by CPET.
Recent Findings: We summarize the basics of exercise physiology and the key determinants of CRF.
Background: Past studies have documented the ability of cardiopulmonary exercise testing to detect cardiac dysfunction in symptomatic patients with coronary artery disease. Firefighters are at high risk for work-related cardiac events. This observational study investigated the association of subclinical cardiac dysfunction detected by cardiopulmonary exercise testing with modifiable cardiometabolic risk factors in asymptomatic firefighters.
View Article and Find Full Text PDFUnlabelled: Peak oxygen pulse (O pulse) may have predictive utility for health outcomes yet, presently, has only been examined in men and only using a single baseline measure.
Purpose: The primary aim of this investigation was to evaluate the relationship between O pulse and all-cause mortality in apparently healthy women and men. A secondary aim was to explore the relationship between longitudinal changes to O pulse and mortality.
Background: Microvascular dysfunction is known to play a key role in patients with angina and nonobstructive coronary artery disease. We investigated the impact of ranolazine among patients with angina and nonobstructive coronary artery disease.
Methods: In this randomized, double-blinded, placebo-controlled pilot trial, 26 patients with angina once weekly or more, abnormal stress test, and nonobstructive coronary artery disease (<50% stenosis by angiography and fractional flow reserve >0.
It has been established that blacks have higher overall incidence and prevalence of hypertension compared to their white counterparts. However, the maximum blood pressure (BP) response of blacks to exercise has not been characterized. A total of 5996 apparently healthy men from the Fitness Registry and Importance of Exercise: A National Database (FRIEND) who underwent maximum cardiopulmonary exercise tests on a cycle ergometer were included in this analysis.
View Article and Find Full Text PDFSodium-glucose cotransporter 2 (SGLT2) inhibitors have been shown to prevent heart failure and reduce cardiovascular death in patients with type 2 diabetes (T2DM) and cardiovascular disease (CVD). Whether or not SGLT2 inhibitors improve indices of cardiorespiratory fitness (CRF), an independent predictor of mortality in patients with CVD, remains unknown. We evaluated the effects of empagliflozin on indices of CRF in patients with T2DM.
View Article and Find Full Text PDFPurpose: Improvements in cardiorespiratory fitness ((Equation is included in full-text article.)O2peak) post-cardiac rehabilitation (post-CR) are used to gauge therapeutic efficacy. The aim of the present study was to assess the effect of supervised CR on other cardiopulmonary exercise testing (CPX) variables, specifically those that reflect ventilatory efficiency and (Equation is included in full-text article.
View Article and Find Full Text PDFPurpose Of Review: There is growing clinical interest for the use of cardiopulmonary exercise testing (CPET) to evaluate patients with or suspected coronary artery disease (CAD). With mounting evidence, this concise review with relevant teaching cases helps to illustrate how to integrate CPET data into real world patient care.
Recent Findings: CPET provides a novel and purely physiological basis to identify cardiac dysfunction in symptomatic patients with both obstructive-CAD and nonobstructive-CAD (NO-CAD).
Background: Symptomatic non-obstructive coronary artery disease is a growing clinical dilemma for which contemporary testing is proving to be of limited clinical utility. New methods are needed to identify cardiac dysfunction.
Methods And Results: This is a prospective observational cohort study conducted from December 2013 to August 2015 in two outpatient cardiology clinics (symptomatic cohort) and 24 outpatient practices throughout the US (healthy cohort) with centralized methodology and monitoring to compare heart-rate responses during cardiopulmonary exercise testing (CPET).
Evidence demonstrating the potential value of noninvasive cardiopulmonary exercise testing (CPET) to accurately detect exercise-induced myocardial ischemia is emerging. This case-based concept report describes CPET abnormalities in an asymptomatic at-risk man with suspected early-stage ischemic heart disease. When CPET was repeated 1 year after baseline assessment, his cardiovascular function had worsened, and an anti-atherosclerotic regimen was initiated.
View Article and Find Full Text PDFEvidence demonstrating the potential value of cardiopulmonary exercise testing (CPET) to accurately detect myocardial ischemia secondary to macro-vascular disease is beginning to emerge. Despite distinct mechanisms mediating ischemia in micro-vascular and macrovascular coronary artery disease (CAD), the net physiologic effect of exercise-induced left ventricular (LV) dysfunction is common to both. The abnormal physiologic response to CPET may, therefore, be similar in patients with macro- and micro-vascular ischemia.
View Article and Find Full Text PDFCardiopulmonary exercise testing (CPET) is a well-accepted physiologic evaluation technique in patients diagnosed with heart failure and in patients presenting with unexplained dyspnea on exertion. Several variables obtained during CPET, including oxygen consumption relative to heart rate and work rate provide consistent, quantitative patterns of abnormal physiologic responses to graded exercise when left ventricular dysfunction is caused by myocardial ischemia. This concept report describes both the methodology and clinical application of CPET associated with myocardial ischemia.
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