Archive for the ‘Pulmonary function’ Category - Part 7

Impact of Integrative Cardiopulmonary Exercise Testing (27)

The evaluation and causes of exertional dyspnea, in a pulmonary disease clinic, were recently described by Pratter et al. In this study, 85 patients were initially evaluated by history, examination, and chest roentgenogram. The physicians diagnostic impression turned out to be correct as to the cause of dyspnea in 66 percent of patients, and was […]

Impact of Integrative Cardiopulmonary Exercise Testing (26)

The usefulness of noninvasive measurements in this disorder was further suggested by D’Alonzo et al in ten patients with obliterative pulmonary hypertension. A strong relationship between change in total pulmonary vascular resistance at rest and exercise after nifedipine or diltiazem therapy and increase in maximum exercise Vo2 and oxygen-pulse were demonstrated. They concluded that changes […]

Impact of Integrative Cardiopulmonary Exercise Testing (25)

Pulmonary vascular disease: Chronic disorders of the pulmonary vasculature are notoriously difficult to diagnose early, especially when the patient s symptoms are attributed to other kinds of lung or heart disease. Frequently ordered tests may be either insensitive or nonspecific, such as radionuclide perfusion scans, or invasive and unsuitable for screening, such as contrast pulmonary […]

Impact of Integrative Cardiopulmonary Exercise Testing (24)

Nevertheless, low work capacity, defined as maximum Vo2 of less than 80 percent predicted, was found in 15 of 16 patients. Maximum Vo2 was less than 50 percent predicted in 7 of 16 patients. These authors concluded that patients with considerably less resting pulmonary dysfunction than defined by certain criteria for disability purposes can still […]

Impact of Integrative Cardiopulmonary Exercise Testing (23)

Recently, pulmonary vasodilators have been administered to patients with COPD with the consideration that the pulmonary circulation limits exercise. In one study, for example, hydralazine reduced pulmonary hypertension, but there was no improvement in symptom-limited maximum 02 uptake. Similar findings were reported by Adnot et al for the pharmacologic vasodilator, urapidil. These studies emphasize the […]

Impact of Integrative Cardiopulmonary Exercise Testing (22)

D’Urzo et al reported that resting Deo and resting 02 saturation would suggest which patients with COPD would desaturate during exercise. They found a strong correlation between these variables, but they only accounted for 65 percent of the observed variance in exercise 02 saturation. Finally, we have recently found that about two thirds of a […]

Impact of Integrative Cardiopulmonary Exercise Testing (21)

Chronic obstructive lung disease (COPD): Because of the physiologic derangement in COPD, spirometry might be anticipated to be highly correlated with exercise performance. However, two factors are important. First, spirometry performed at rest only estimates a patients ventilatory capacity and not the ventilatory requirement for exercise. The latter depends on the degree of ventilation-perfusion mismatching […]

Impact of Integrative Cardiopulmonary Exercise Testing (20)

This concept of diastolic dysfunction being a primary determinant of exercise limitation in heart failure patients may explain why gas exchange measurement of exercise performance, ie, maximum Vo2 and AT, does not correlate with resting LV systolic performance variables such as LV ejection fraction. Furthermore, there are also important implications of this proposed mechanism for […]

Impact of Integrative Cardiopulmonary Exercise Testing (18)

Furthermore, exercise training in these patients over a period of four to six months resulted in delayed blood lactate accumulation accompanied by an increased AT by about 20 percent. The authors concluded that the gas exchange AT provides a useful index of change in submaximal exercise performance after an intervention. Their findings were supported by […]

Impact of Integrative Cardiopulmonary Exercise Testing (17)

Furthermore, the maximum Vo2 in patients with chronic heart failure had a strong relationship with maximum cardiac index during treadmill exercise. Patients with maximum Vo2 greater than 20 ml/min/kg had cardiac index greater than 8 L/min/m2, whereas those with maximum Vo2 less than 10 ml/min/kg had maximum cardiac index less than 4 ml/m in/m2. Importantly, […]

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