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PubMed1991

Exercise testing and training in patients with peripheral vascular disease and lower extremity amputation.

Patients with peripheral vascular disease have a high risk of coronary artery disease. The risk is even greater when the peripheral vascular disease leads to lower extremity amputation. Exercise testing using lower extremity exercise has been the "gold standard" for screening for coronary artery disease, but many patients with peripheral vascular disease and those with amputations have difficulty doing this type of exercise. Arm exercise ergometry has been shown to be a safe and effective alternative for the detection of coronary artery disease in patients who cannot do leg exercise. This test has also been used to determine safe exercise levels and may be able to predict the ultimate level of prosthetic use in amputees. Exercise training with arm ergometry also improves cardiovascular efficiency and upper body strength in poorly conditioned patients. Studies are needed to appreciate fully the role of exercise testing and training in the recovery of these patients after amputation.

Amputation, Surgical↗
PubMed1991

[Anaerobic "all-out" stress tests: selection of the type and duration of stress].

In the diagnosis of prerequisite conditions for short-term highly intensive activity, performed under conditions of oxygen deficit anaerobic loading tests are used. Contrary to tests of constant performance, "all-out" tests follow up changes of performance in the course of time, i. e. they record the maximal anaerobic performance as well as the decline of performance in the course of the test. In a group of 17 subjects three types of loads were compared (bicycle ergometry, a test repeated jumps and running) and two periods of anaerobic tests--45 s and 120 s. The results achieved in different tests--total work, maximum performance, decline of performance, post-load lactate concentration in blood--differed depending on the type of load and duration of the test. Correlation analysis did not reveal a close relationship between the results of different anaerobic tests, there was however a relationship between the maximum performance and the total work at the level of general physical fitness. The longer variant of the test--120 s--did not prove more suitable, neither from the aspect of the assumed markedly higher lactate cumulation in blood nor from the aspect of maximum performance, as compared with the 45 s test. A close relationship was revealed between the results of the 45 s and 120 s jumping and running test but not between the results of bicycle ergometry. The post-load lactate concentration cannot be considered a highly reliable indicator of the level of the anaerobic energy metabolism in the working muscle.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Effects of pedaling speed on the power-duration relationship for high-intensity exercise.

Seven males (age = 20.4 +/- 0.3 yr) each performed a total of eight exhaustive exercise bouts (four at 60 rpm and four at 100 rpm) in order to determine the influence of pedaling frequency on the parameters of the power-duration relationship for high-intensity cycle ergometry. The power-endurance time data for each subject at each rpm were fit by nonlinear regression to extract parameters of the hyperbolic: (P - theta PA). t = W', where P = power output, t = time to exhaustion, and theta PA and W' are constants. theta PA (the power asymptote, in watts (W] reflects an inherent characteristic of aerobic energy production during exercise, above which only a finite amount of work (W', in joules) can be performed, regardless of the rate at which the work is performed. theta PA at 60 rpm (235 +/- 8 W) was significantly (15.9 +/- 4.5%, P less than 0.05) greater than theta PA at 100 rpm (204 +/- 11 W), thus confirming our hypothesis that endurance would be compromised while cycling at the higher pedaling frequency. In contrast, W' was not significantly (P greater than 0.05) affected by cadence (16.8 +/- 1.7 kJ at 60 rpm vs 18.9 +/- 2.2 kJ at 100 rpm). Our data are consistent with the implications of previous investigations which demonstrated a greater cardiorespiratory and blood/muscle lactate response during constant-power exercise while cycling at high vs low rpm and indicate that the theoretical maximum sustainable power (i.e., theta PA) during cycle ergometry in untrained males is greater at 60 rpm than at 100 rpm.

Acceleration↗
PubMed1991

[Characteristics of the cardiovascular system in children with primary arterial hypotension].

Overall 120 children aged 12 to 15 years with primary arterial hypotension and different variants of the disease course (grave, of medium gravity or mild) were examined. The control group was made up to 50 normal children. The program of the examination included electrocardiography, echocardiography, tetrapolar chest rheography and bicycle ergometry. It has been established that in children with arterial hypotension, the intracardiac hemodynamics undergoes compensatory adaptive reconstruction characterized by the enhancement of contractile and pump functions of the myocardium combined with the increased relaxation capacity. The central hemodynamics is characterized by the lowering of the general peripheral vascular resistance. The functional potentialities of the cardiovascular system decline, manifesting in the form of a decrease of exercise tolerance in association with energy losses necessary for its performance. The use of bicycle ergometry made it possible to delineate dysadaptation reactions of arterial pressure to exercise, modified by hereditary factors.

Adolescent↗
PubMed1991

[Potential for early diagnosis of myocardial contractility disorders in people working under unfavorable conditions].

As many as 76 practically healthy men, workers of the pipe rolling plant, were examined at rest and during bicycle ergometry using M-echocardiography and visual-retrieval doppler-echocardiography. At rest none of the examined manifested any disorders of myocardial contractility. During bicycle ergometry, workers engaged in physical labour, both easy and of medium gravity, showed a rise of myocardial contractility as the loading was increased (at usual temperatures). In persons engaged in hard physical labour and exposed to the heating microclimate, the stroke volume, ejection fraction and Vcf calculated according to the echocardiogram rose whereas no increment of the contraction and relaxation rates was recorded, which was recognized as a sign of depletion of myocardial contractility reserves.

Adult↗
PubMed1990

[Mechanocardiography in modern cardiology].

The importance of noninvasive methods in cardiology has continuously been increasing; beside electrocardiography, phonocardiology, bicycle ergometry, echocardiography, radioisotopic examination and nuclear magnetic resonance, mechanocardiography preserves its significance, too. There are several reasons for it: modern apparatus technique has brought a pronounced increase in examination accuracy, comparison with invasive methods showed a number of mechanocardiographic data to be of value for left ventricular function evaluation, mechanocardiography is especially useful in repeated and long-term functional observation of the left ventricle, evaluation of treatment effects, revealing the onset of left ventricular dysfunction, the method is relatively economical and applicable even in peripheral workplaces. The literature survey of the study sums up the present knowledge of mechanocardiographic techniques, the genesis of curves and the manner of their evaluation, the physiological and other influences on the mechanocardiographic data and their clinical utilization. An analysis of experience gathered in a number of laboratories all over the world demonstrates the need of further improvement and development of the method. The present dissertation is aimed at this goal. I has set itself a task to contribute to the solution of some methodological problems of mechanocardiography and to evaluate critically its importance for the clinical practice. Polygraphy and apexcardiography (including 1st derivatives of curves) performed both at rest and during isometric handgrip exercise were used. From the obtained curves a wide spectrum of parameters was determined and several indices were calculated, some of them being introduced originally. The mechanocardiographic data were correlated in some studies with the results of echocardiography and bicycle ergometry and with invasive examination (heart catheterization, coronarography). The following results were obtained in the research into mechanocardiographic methodology problems: the suitability of a LPA 100 transducer of Czechoslovak production (Tesla VUST) was demonstrated; some physiological influences on the obtained values were determined (effects of age, respiration, body weight). The author's own method of cardiac cycle intervals correction to comparable values at unified cycle duration was elaborated; the effects of isometric handgrip exercise were studied in detail. The work was focused on verifying the importance of mechanocardiography for clinical cardiology. Therefore the method was used in a number of diseases and pathological conditions to get more complex experience. On the basis of the results obtained the value of mechanocardiography application in coronary artery disease has been demonstrated. The method provides a certain possibility in CAD diagnosis by means of combined evaluation of three sensitive parameters (pulse transmission time and two parameters of alpha wave amplitude). This type of valuation has been proposed by our laboratory.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1990

[Treatment indications of hypertensive blood pressure dysregulation (a 7-year follow-up)].

The results of the present course investigations by means of bicycle ergometry over seven years on patients with vitality-limiting load hypertension in normotensive and initial situation of the borderline blood pressure, respectively, render necessary from the point of view of the authors an increase of the former indications to treatment. Situative measurement of blood pressure only at rest are hereby not sufficient and demand a bicycle-ergometric objectivation of the possible hypertensive dysregulation of blood pressure in patients with anamnestically restricted range of physical efficacy. In patients with exclusively under load increased vitality-limiting blood pressure values the ergometry represents the diagnostic method of choice.

Adult↗
PubMed1978

[Cyclic nucleotides in the blood plasma in arterial hypertension].

The reaction of cyclic nucleotides in blood to an orthostatic position, furosemid administration, and submaximal bicycle ergometry load was studied in 20 healthy individuals and in 50 patients with hypertensive disease. A special group was composed of 25 patients the disease in whom was marked by crises. It is shown that a walk of one hour and intravenous infusion of 40 mg of furosemid caused an increase in the blood cAMP but did not change the level of cGMP. During a bicycle ergometry load the levels of cGMP and cGMP increased to an equal measure and returned to their initial values 30 min after its cessation. In patients with arterial hypertension the cGMP system becomes most functionally mobile, whereas the cAMP level, if it increases, does so at a later term after the effect of the stimulus begins. The increased cGMP level is maintained for quite a lengthy period of time after the load is discontinued. In patients suffering from hypertensive disease with crises the cAMP/cGMP ratio, which is reduced at rest also, diminishes still more in an orthostatic position and particularly during a crisis. The role of changes in the metabolism of cyclic nucleotides and their sensitivity to regulatory factors in the pathogenesis of arterial hypertension is discussed.

Cyclic AMP↗
PubMed1990

[Effectiveness of nifedipine, diltiazem and their combination in the treatment of chronic stable angina pectoris].

In a double blind crossed ten-week study with a randomized beginning the authors compared in 25 patients with chronic stable angina pectoris (II-III according to NYHA classification) and with normal blood pressure the effect of placebo, nifedipine, diltiazem and in 16 of the patients (who completed treatment with the combined drugs) also a combination of nifedipine and diltiazem. Nifedipine, 60 mg per day, and diltiazem, 270 mg per day, improved significantly the total amount of performed work as compared with placebo, they delayed significantly the onset of stenocardias and reduced the ST depression in lead V5 during ergometry, they reduced significantly the rate of stenocardias per day as well as the nitroglycerin consumption. Diltiazem, as compared with nifedipine, increased significantly the total volume of performed work and delayed the development of stenocardias during ergometry, the symptomatic improvement of the patients being similar. A combination of 30 mg nifedipine per day with 180 mg diltiazem per day did not lead to improvement, as compared with a higher dose of diltiazem alone, as compared with a higher dose of diltiazem alone. A combination of 60 mg nifedipine per day with 270 mg diltiazem per day did not improve the exercise tolerance, as compared with diltiazem alone, however, it reduced significantly the rate of stenocardias. However, the combination of the latter amounts was tolerated without side-effects only by 13% of the patients (2 of 15 patients), 53% (8 of 15 patients) terminated treatment prematurely because of several side-effects.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[Clinico-instrumental characteristics of the state of the myocardium of patients with long Q-T interval syndrome detected during a population survey].

A comprehensive clinical and instrumental study involving the collection of complaints, resting ECG records, bicycler ergometry, Holter monitoring, echocardiography was performed in 80 Novosibirsk's residents (66 males and 14 females) aged 25-64 years who had the prolonged Q-T interval syndrome detected during a population survey. ECG frequently showed the early ventricular repolarization syndrome (23%) in males and left ventricular hypertrophy (36%) in females. Bicycle ergometry increased Q-T interval in 11% of males and decreased or unchanged it in the remaining cases. Holter monitoring revealed cardiac arrhythmias in 39% of males and 64% of females, supraventricular and monotopic ventricular premature beats being prevalent. The method was found to have advantages in detecting arrhythmias. Echocardiography performed in males made it possible to identify ventricular septum hypertrophy (40%) and mitral valve prolapse (20%). The examinees with the prolonged Q-T interval syndrome mostly had arterial hypertension, coronary heart disease, and alcoholic cardiomyopathy.

Adult↗
PubMed1990

[A comparative evaluation of loading tests for the diagnosis of ischemic heart disease at the prehospital stage].

Bicycle ergometry, the treadmill test, transesophageal pacing of the left atrium and 24-h monitoring of the ECG were performed on an outpatient basis in 82 persons (all men) with angina pectoris of effort and stenosing atherosclerosis of the coronary arteries verified with the aid of selective coronarography and in 17 men with intact coronary arteries. Transesophageal pacing and the treadmill test exhibited the highest sensitivity (94 and 89%, respectively) in the diagnosis of the latent forms of coronary failure. The sensitivity of bicycle ergometry (77%) was significantly lower which was caused by a considerable number (21%) of tests completed before the appearance of diagnostic criteria. Meanwhile the results of 24-h monitoring of the ECG (65% sensitivity) depended on the degree of the patients' physical activity and way of life. All the four methods did not significantly differ in the specificity. Proceeding from the data obtained it is recommended that the treadmill test and transesophageal pacing of the heart may be widely used on an outpatient basis to diagnose coronary disease.

Adult↗
PubMed1986

[Rhythm and conduction disorders in alcoholic lesions of the heart].

Combined investigation (bicycle ergometry, daily ECG monitoring, electrophysiologic studies, coronarography and ventriculography) in 46 alcoholic patients established ventricular extrasystole, paroxysmal atrial fibrillation, atrioventricular block as well as reduced ejection fraction and increased end systolic ventricular volume in the majority of those. Daily ECG recording, bicycle ergometry and electrophysiologic studies proved to be particularly sensitive in detecting cardiac arrhythmias in the alcohol-damaged heart.

Adult↗
PubMed1988

[Newly developed stenocardia: lack of ventricular electrical instability in the absence of acute myocardial ischemia].

A total of 130 patients with angina of new onset were examined within first 3 months of the disease. Macrofocal myocardial infarction survivors were not admitted to the study. The investigation included selective coronaro-angiography and ventriculography, Holter's ECG monitoring over 24 to 48 hours and bicycle ergometry. Programmed right-ventricular electric stimulation was conducted in 41 patients. Only one major coronary artery was affected in 78% of patients. Left-ventricular ejection fraction nearly always exceeded 50%. Groups of ventricular extrasystoles were detected by ECG monitoring in 10.8% and by bicycle ergometry in 2.5%. No signs of electrical instability were ever detected at programmed stimulation, done in the absence of anginal attacks. Groups of ventricular extrasystoles were more common, as compared to single extrasystoles (p less than 0.001), in acute myocardial ischemia, being more frequently associated with unstable rather than stable angina of new onset (p less than 0.05). In early coronary heart disease, signs of electric ventricular instability are not detectable in the absence of myocardial ischemia.

Adult↗
PubMedDate not supplied

[Diagnosis of cardiac rhythm disorders in pilots using 24-hour ECG monitoring].

As a result of comprehensive examinations of 57 pilots, aged 31 to 50 years, which included multi-step bicycle ergometry, specific tests simulating flight effects (e.g., positive pressure breathing, moderate hypoxia, radial acceleration) and 24-hour Holter monitoring, various cardiac arrhythmias were identified in 37 subjects (64.9%). They included supraventricular ectopic beats and ventricular ectopic beats of different grades. It was demonstrated that Holter monitoring was very reliable in comparison with conventional methods such as ECG at rest, bicycle ergometry or specific tests. In 5 cases, transient cardiac arrhythmias were associated with ischemic heart disease manifestations. The method of Holter monitoring is recommended to be used in medical expertise of the aircraft personnel.

Adult↗
PubMed1989

[Study of the informative value of Holter ECG monitoring and exercise test in ventricular arrhythmia in patients with ischemic heart disease and a high degree of myocardial electric instability, based on the data of programmed electric stimulation of the heart ventricles].

A total of 118 individuals were investigated to assess the value of Holter's ECG monitoring and bicycle ergometry for the identification of coronary patients predisposed to dangerous arrhythmias. Programmed ventricular stimulation was carried out: 1, 2 and 3 electric stimuli from the apex and/or outflow pathway of the right ventricle were applied in the presence of a pacemaker operating at 100 and 140 imp/min rates. The analysis of 24-hour ECG records demonstrated a correlation between some parameters (number of different ventricular extrasystole configurations, presence of high-grade ventricular arrhythmias) and the magnitude of myocardial electric instability, as shown by electric stimulation. An emergence or essential increase in ectopic ventricular activity during bicycle ergometry is not a precursor of myocardial instability at programmed pacemaker stimulation. At the same time, the absence of ventricular arrhythmias in response to stress does not exclude high-grade myocardial instability, detectable at programmed pacemaker stimulation.

Adult↗
PubMed1989

Effects of penbutolol on plasma atrial natriuretic peptide and antidiuretic hormone levels before and after exercise: a double-blind comparison against placebo.

A double-blind crossover trial was carried out in 7 healthy male volunteers to investigate the effects of penbutolol and a placebo on plasma atrial natriuretic peptide (ANP) and antidiuretic hormone (ADH) levels before and after exercise. Each subject underwent several bicycle ergometric exercises lasting 6 min before and after the application of test medications. Ergometric exercises were performed before medication, and at 2, 5, 9 and 24 hours after medication. Blood samples for ANP and ADH levels were drawn before, after 15 min, after 2 hours (immediately after ergometry) and 5, 7, 9, and 24 hours after medication (immediately before ergometry). Urine was collected as follows: -2 to 0, 0 to 2, 2 to 4, 4 to 7, 7 to 14 and 14 to 24 hours after medication, and the volume as well as sodium excretion were documented. Penbutolol caused suppression of the exercise-induced increase in ANP. The 2 to 4 hour fractional sodium excretion was significantly decreased from 12.1 +/- 4.9 mmol/fraction after placebo treatment to 7.8 +/- 3.0 mmol/fraction after penbutolol application (p less than 0.03). There were no differences in the urinary outputs between penbutolol and placebo until 4 hours after medication, but penbutolol caused the total urinary output to increase from 1390 +/- 388 ml/24 hr during placebo treatment to 1725 +/- 549 ml/24 hr (p less than 0.02) due to the last collection fraction. Blood pressure and pulse rate both decreased during exercise after penbutolol. As opposed to the suppressing influence of penbutolol on ANP, ADH plasma levels were increased after exercise.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

Selection of appropriate exercise regimens for weight reduction during VLCD and maintenance.

Body composition, resting metabolic rate (RMR) and physical work capacity (aerobic capacity) were measured in four groups of 10 overweight women during 8 weeks of VLCD (405 kcal/day (42 g protein] followed by 8 weeks of 1500 kcal/day maintenance with two additional non dieting groups as controls. Five groups, i.e. two control groups plus three dieting groups, undertook exercise in bicycle ergometry (aerobic) or isotonic resistance or 8 week ergometry followed by 8 week resistance. Weight loss and body composition patterns were similar in diet and diet and exercise groups but efficiency of residual FFM in isotonic resistance groups improved significantly (P less than 0.05). Strength gains/kg body weight significantly improved (P less than 0.05) in the isotonic and dieting group. We conclude that exercise with VLCD is beneficial particularly isotonic resistance training, in improving muscular efficiency and RMR/lean.

Adult↗
PubMedDate not supplied

[The rehabilitation of patients with diabetes mellitus and ischemic heart disease].

The results of bicycle ergometry testing were studied in 20 patients with diabetes mellitus of type II without clinical signs of circulatory insufficiency, 21 patients with postinfarction cardiosclerosis with undisturbed carbohydrate tolerance, and in 18 healthy persons. The blood level of glucose in patients with diabetes mellitus was investigated on an empty stomach and 30, 60 and 120 min. after physical exercising. Similar changes of bicycle ergometry results were found in diabetic and CHD patients. In compensation of diabetes in response to graded physical exercise glycemic changes were absent, in decompensation glycemia increased in 30 and 60 min. and returned to the basal level 120 min. after testing. Since the results of bicycle exercises in diabetic (compensated) and CHD patients were the same, the principles of their physical rehabilitation must be identical. In patients with decompensated diabetes mellitus a hyperglycemic reaction to graded physical exercise serves the basis for reduction of motor activity in patients with decompensated diabetes mellitus.

Adult↗