Long-term stability of the oxygen pulse curve during maximal exercise

INTRODUCTION: Exercise oxygen pulse (O2 pulse), a surrogate for stroke volume and arteriovenous oxygen difference, has emerged as an important variable obtained during cardiopulmonary exercise testing. OBJECTIVES: We hypothesized that the O2 pulse curve pattern response to a maximal cycling ramp protocol exhibits a stable linear pattern in subjects reevaluated under the same clinical conditions. METHODS: We retrospectively studied 100 adults (80 males), mean age at baseline of 59 + 12 years, who performed two cardiopulmonary exercise testings (median interval was 15 months), for clinical and/or exercise prescription reasons. The relative O2 pulse was calculated by dividing its absolute value by body weight. Subjects were classified into quintiles of relative O2 pulse. Cardiopulmonary exercise testing results and the O2 pulse curve pattern, expressed by its slope and intercept, were compared among quintiles of relative O2 pulse at both cardiopulmonary exercise testings. RESULTS: After excluding the first minute of CPX (rest-exercise transition), the relative O2 pulse curve exhibited a linear increase, as demonstrated by high coefficients of determination (R² from 0.75 to 0.90; p<0.05 for all quintiles). Even though maximum oxygen uptake and relative O2 pulse were significantly higher in the second cardiopulmonary exercise testing for each quintile of relative O2 pulse (p<0.05 for all comparisons), no differences were found when slopes and intercepts were compared between the first and second cardiopulmonary exercise testings (p>0.05 for all comparisons; except for intercept in the 5th quintile). CONCLUSION: Excluding the rest-exercise transition, the relative O2 pulse exhibited a stable linear increase throughout maximal exercise in adults that were retested under same clinical conditions

Influence of central obesity in estimating maximal oxygen uptake

OBJECTIVE: To assess the influence of central obesity on the magnitude of the error of estimate of maximal oxygen uptake in maximal cycling exercise testing. METHOD: A total of 1,715 adults (68% men) between 18-91 years of age underwent cardiopulmonary exercise testing using a progressive protocol to volitional fatigue. Subjects were stratified by central obesity into three quartile ranges: Q1, Q2-3 and Q4. Maximal oxygen uptake [mL.(kg.min)-1] was estimated by the attained maximal workload and body weight using gender- and population-specific equations. The error of estimate [mL.(kg.min)-1] and percent error between measured and estimated maximal oxygen uptake values were compared among obesity quartile ranges. RESULTS: The error of estimate and percent error differed (mean ± SD) for men (Q1=1.3±3.7 and 2.0±10.4; Q2-3=0.5±3.1 and -0.5±13.0; and Q4=-0.3±2.8 and -4.5±15.8 (

The slope of the oxygen pulse curve does not depend on the maximal heart rate in elite soccer players

INTRODUCTION: It is unknown whether an extremely high heart rate can affect oxygen pulse profile during progressive maximal exercise in healthy subjects. OBJECTIVE: Our aim was to compare relative oxygen pulse (adjusted for body weight) curves in athletes at their maximal heart rate during treadmill cardiopulmonary exercise testing. METHODS: A total of 180 elite soccer players were categorized in quartiles according to their maximum heart rate values (n = 45). Oxygen consumption, maximum heart rate and relative oxygen pulse curves in the extreme quartiles, Q1 and Q4, were compared at intervals corresponding to 10% of the total duration of a cardiopulmonary exercise testing. RESULTS: Oxygen consumption was similar among all subjects during cardiopulmonary exercise testing; however subjects in Q1 started to exhibit lower maximum heart rate values when 20% of the test was complete. Conversely, the relative oxygen pulse was higher in this group when cardiopulmonary exercise testing was 40% complete (p<.01). Although the slopes of the lines were similar (p = .25), the regression intercepts differed (p<.01) between Q1 and Q4. During the last two minutes of testing, a flat or decreasing oxygen pulse was identified in 20% of the soccer players, and this trend was similar between subjects in Q1 and Q4. CONCLUSION: Relative oxygen pulse curve slopes, which serve as an indirect and non-invasive surrogate for stroke volume, suggest that the stroke volume is similar in young and aerobically fit subjects regardless of the maximum heart rate reached

Distância do domicílio ao local de exercício físico não influenciou a aderência de 796 participantes

Fundamento: Uma das dificuldades para a manutenção da aderência de longo prazo a exercícios é a distância entre domicílio e local de exercício. Objetivo: Determinar, para um programa de exercício físico supervisionado (PES) privado, a influência da distância domicílio-PES sobre a aderência. Métodos: Foram identificados 976 sujeitos e selecionados 796 que atendiam aos critérios de inclusão. A distância domicílio-PES foi obtida pelo Google Maps. A aderência foi determinada em quartis (meses): de 1 a 4, 5 a 12, 13 a 36 e mais de 36. As condições clínicas foram estratificadas como: saudáveis; obesos e/ou hipertensos e/ou dislipidêmicos e/ ou diabéticos sem doença coronariana; coronariopatas e outros agravos como câncer, pânico e doenças respiratórias. A distância domicílio-PES foi dividida em (km): até 1, entre 1 e 3, entre 3 e 10, e mais de 10. Para a análise estatística, utilizaram-se a ANOVA Kruskal-Wallis e o qui-quadrado. Resultados: Dos participantes, 46% residiam até 3 km, 39% entre 3 e 10 km e cerca de 15% moravam a mais de 10 km do local de realização do PES. Não foram encontradas diferenças entre as medianas dos meses de permanência no PES em função da distância domicílio-PES (p = 0,11). Conclusão: Para um determinado PES privado da cidade do Rio de Janeiro e funcionando de segunda a sábado com livre escolha de horário, a distância domicílio-PES não influenciou na aderência dos participantes. Isso provavelmente se deveu à qualidade do serviço prestado e/ou a ausência de opções mais próximas do local de domicílio dos participantes. _________________________________________________________________________________________ ABSTRACT: Background: One of the difficulties in maintaining long-term adherence to exercise is the distance from home to the place of exercise. Objective: To determine, for a private supervised exercise program (PSEP), the influence of the home-PSEP distance on adherence. Methods: We identified 976 individuals and selected 796 who met the inclusion criteria. The home-PSEP distance was obtained by the Google Maps. Adherence was determined by quartiles (months): 1-4, 5-12, 13-36 and more than 36. The clinical conditions were stratified as healthy, obese and/or hypertensive and/or dyslipidemic and/or diabetic patients without coronary disease; coronary artery disease patients and other health problems like cancer, respiratory disease and panic. The home-PSEP distance was divided into (km): up to 1, 1 to 3, 3 to 10 and more than 10. For the statistical analysis, we used the Kruskal-Wallis ANOVA and the chi-square test. Results: Of respondents, 46% lived up to 3 km, 39% lived between 3 and 10 km and about 15% lived more than 10 kilometers from the place of the PSEP. No differences were found between the medians of the months of participation in the PSEP as a function of home-PSEP distance (p = 0.11). Conclusion: For a given PSEP in the city of Rio de Janeiro, open from Monday through Saturday with free choice of time, the home-PSEP distance did not influence the adherence of participants. This was probably due to the quality of the service and/or lack of places closer to the participants’ home. (Arq Bras Cardiol 2012;98(6):553-558) Keywords: Rehabilitation; training; exercise; coronary artery disease

Sitting and rising from the floor are influenced by morphologic and functional variables

We aim to study the influence of morphologic and functional variables on the actions of sitting and rising from the floor, as assessed by the Sitting-Rising Test (SRT). Randomly, in the 160 physically active policemen, we selected 42, from those who achieved the maximal score in both actions of the SRT and 49, from the others. The age ranged from 18 to 45 years (74 ± 10 kg and 176 ± 7 cm [mean ± sd]). We also evaluated or calculated: abdominal girth (AG), sum of six skinfolds (6sf Z), body fat percentage (BF%), BMI, superior to inferior skinfolds ratio (SISR), specific and general flexibility in 11 movements (Flexitest), maximun standing long jump distance (MSLJD) and balance (Romberg test). Factor analysis did not identify the presence of sitting and rising performance in any of the four factors that explained 69% of the total sample variance. Multiple regression verified an association between sitting and SLJD, BMI, AG and ankle flexibility, and between rising and SLJD, AG, age and general flexibility (p &lt; 0.01). The canonical analysis showed that the performances in the actions, when evaluated together, provide a stronger association with age, BMI, SISR, SF Z, AG, SLJD, and with ankle, knee, hip and trunk flexibility (rc = 0.63, p &lt; 0.01). We conclude that the SRT can provide simple indicators of functional fitness in adultsObjetivamos estudar a influência de variáveis morfo-funcionais nas ações de sentar e levantar do solo, avaliadas pelo Teste Sentar-Levantar (TSL). Randomicamente, em 160 policiais fisicamente ativos, selecionamos 42, dentre os que alcançaram escore máximo nas ações do TSL, e 49, dentre os demais. A idade variou entre 18 a 45 anos (74 ± 10 kg e 176 ± 7 cm [média ± dp]). Foram medidos ou calculados: circunferência abdominal (CA), somatória de seis dobras cutâneas (X 6dc), percentual de gordura (% g), IMC, relação entre dobras cutâneas superiores e inferiores (RDCSI), flexibilidade específica e geral em 11 movimentos (Flexiteste), distância em salto horizontal máximo (DSHM) e equilíbrio (Teste de Romberg). A análise fatorial não identificou o desempenho nas ações de sentar e levantar em qualquer um dos quatro fatores que explicavam 69% da variação total da amostra. A regressão múltipla verificou associações entre o sentar e DSHM, IMC, CA e flexibilidade de tornozelo e entre o levantar e DSHM, CA, idade e flexibilidade geral (p &lt; 0,01). A análise canônica apontou que os desempenhos, se avaliados em conjunto, foram mais associados com idade, IMC, RDCSI, X 6dc, CA, DSHM, e flexibilidade no tornozelo, joelho, quadril e tronco (rc = 0,63, p &lt; 0,01). Conclui-se que o TSL pode fornecer indicadores simples da aptidão funcional em adulto

Prevalência de transtornos psiquiátricos e ansiedade relacionada à saúde em coronariopatas participantes de um programa de exercício supervisionado

BACKGROUND: Psychological factors such as stress and depression have already been established as risk factors for cardiovascular disease. More recently, the impact of anxiety has been addressed. OBJECTIVE: To identify psychiatric disorders and assess health- and cardiac-related anxiety in coronary artery disease patients attending a supervised exercise program. METHODS: Forty-two male cardiac patients were interviewed using the Mini International Neuropsychiatric Interview (MINI) version 5.0 and instructed to complete the Anxiety Sensitivity Index, the Agoraphobic Cognitions Questionnaire, the Body Sensations Scale, and the Cardiac Anxiety Questionnaire. RESULTS: Thirty-eight percent of the participants presented with one or more psychiatric disorders (PDs) but only 19% presented with multiple PDs. Psychiatric disorders were associated with higher health- and cardiac-related anxiety scores (p < 0.05). No relationship was found between these anxiety scores and the severity of cardiovascular disease (p &gt; 0.05). DISCUSSION: Health-related anxiety seems to be more strongly associated with the presence of psychiatric comorbidities in cardiac patients than with the severity of cardiovascular disease. Screening of all cardiac patients for past and present psychiatric symptoms should be implemented. Interventional strategies, including exercise and counseling, warrant further research.CONTEXTO: Aspectos psicológicos como estresse e depressão já são reconhecidos como fatores de risco cardiovascular. Mais recentemente, o impacto da ansiedade passou a ser objeto de estudo. OBJETIVO: Identificar a prevalência de transtornos psiquiátricos e a presença de ansiedade relacionada à saúde e de ansiedade cardíaca em coronariopatas participantes de um programa de exercício supervisionado. MÉTODOS: Quarenta e dois homens coronariopatas foram entrevistados com o Mini International Neuropsychiatric Interview (MINI), versão 5.0, e solicitados a preencher a Escala de Sensibilidade à Ansiedade, o Questionário de Cognições Agorafóbicas, a Escala de Sensações Corporais e o Questionário de Ansiedade Cardíaca. RESULTADOS: Dentre os participantes, 38% apresentaram um ou mais diagnósticos psiquiátricos pelo MINI, mas apenas 19% apresentaram múltiplas comorbidades. A presença de transtornos psiquiátricos encontra-se associada a escores mais altos de ansiedade relacionada à saúde e à ansiedade cardíaca (p < 0,05). Não foi encontrada relação entre os escores de ansiedade e a gravidade da doença cardiovascular (p &gt; 0,05). CONCLUSÕES: Ansiedade relacionada à saúde parece estar mais fortemente associada à presença de comorbidades psiquiátricas do que à gravidade do quadro cardiovascular. Recomenda-se a triagem regular de pacientes coronariopatas para transtornos psiquiátricos. Estratégias terapêuticas complementares como exercício físico e psicoterapia podem ser alternativas terapêuticas complementares