Archive for the ‘Pulmonary function’ Category - Part 9

Impact of Integrative Cardiopulmonary Exercise Testing (6)

Interpreting Gas Exchange Measurments During Exercise The responses of the cardiovascular system (heart and systemic circulation), pulmonary system (lungs and pulmonary circulation), and the exercising muscles must be closely coupled during exercise. Thus, there is interaction between the organs requiring increased transport of 02 and C02 and the organ systems responsible for delivery of 02 […]

Impact of Integrative Cardiopulmonary Exercise Testing (5)

The detection of abnormal cardiovascular function depends on measurement of the rate of Vo2 change in response to work rate change and not the steady-state measurement. Cheap Diskus Advair Carbon dioxide output (VcoJ is also influenced by cardiovascular function. For example, an important hallmark of cardiovascular disease is the accumulation of lactic acid at abnormally […]

Impact of Integrative Cardiopulmonary Exercise Testing (4)

Oxygen uptake (Vo2 by the lungs and carbon dioxide output (VcOg) from the lungs are often considered to be measurements solely of lung function. However, Fick pointed out in 1870 that mass transfer of Oz from air to blood must be dependent on cardiac output and the difference between 02 content of the mixed venous […]

Impact of Integrative Cardiopulmonary Exercise Testing (3)

We most often use a cycle ergometer for integrative cardiopulmonary exercise testing and make measurements during an exercise protocol in which the work rate is increased in a stepwise manner each minute. The protocol is designed to reach the maximum capacity of the patient between 8 and 12 minutes of the incremental exercise period. The […]

Impact of Integrative Cardiopulmonary Exercise Testing (2)

What Is an Integrative Cardiopulmonary Exercise Test? The integrative cardiopulmonary exercise test allows the simultaneous measurement during known exercise stress of the following: (1) the balance between oxygen supply to the myocardium and myocardial oxygen requirement, assessed primarily from changes indicating ischemia on the electrocardiogram; (2) the adequacy of oxygen delivery (a cardiovascular function) to […]

Impact of Integrative Cardiopulmonary Exercise Testing (1)

Ambulation and physical activity are essential contributors to quality of life. When a patient complains of reduced exercise capacity due to fatigue or exertional dyspnea, how should the physician most efficiently and effectively investigate the problem? antibiotic levaquin Two important factors should be considered. First, many commonly encountered medical conditions, such as heart disease, lung […]

Elevated Pulmonary Artery Pressure: Discussion (Part 6)

The finding that PAMP correlates positively with aortic mean pressure and LV mass suggests that a stimulus raising vascular tone affects both the pulmonary circulation and the systemic circulation. Overresponsiveness of pressures in both vascular beds has been shown to occur with both adrenergic stimuli and exercise in hypertensive patients,- and there is evidence that […]

Elevated Pulmonary Artery Pressure: Discussion (Part 5)

A recent clinical trial among mildly hypertensive patients demonstrated that despite regression of LV mass with blood pressure control, diastolic filling rates did not return to normal. These findings suggest that the diastolic abnormalities of hypertensive heart disease may persist after reduction in protein mass. Similar loss of compliance may have occurred among the third […]

Elevated Pulmonary Artery Pressure: Discussion (Part 4)

In the present analysis, it is apparent that the presence of LVH and increased PAMP have both an independent and an interactive effect on mortality. The interactive effect of LVH and elevated PAMP is best illustrated by the estimated fivefold increase in mortality when these two conditions coexist. Although the nature of this interaction is […]

Elevated Pulmonary Artery Pressure: Discussion (Part 3)

Several important caveats apply, however. First, pulmonary pressure during routine cardiac catheterization is a crude physiologic measure of LV compliance. A number of conditions, including, among others, the geometry of the left ventricle,- loading conditions, and myocardial ischemia, influence diastolic function and make it difficult to obtain accurate estimates of compliance. Second, increases in pulmonary […]

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