scholarly journals P1398 Echocardiographic continuous monitoring of exercise stress test using probe fixation device

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
K Wdowiak-Okrojek ◽  
P Wejner-Mik ◽  
Z Bednarkiewicz ◽  
P Lipiec ◽  
J D Kasprzak
Keyword(s):  
Image Quality ◽  
Physical Exercise ◽  
Stress Test ◽  
Exercise Stress Test ◽  
Bicycle Ergometer ◽  
Exercise Stress ◽  
Fixation Device ◽  
The Mean ◽  
First Time

Abstract Background Stress echocardiography (SE) plays an important role among methods of noninvasive diagnosis of ischemic disease. Despite the advantages of physical exercise as the most physiologic stressor, it is difficult (bicycle ergometer) or impossible (treadmill) to obtain and maintain the acoustic window during the exercise. Recently, an innovative probe fixation device was introduced and a research plan was developed to assess the feasibility of external probe fixation during exercise echocardiography on a supine bicycle and upright treadmill exercise for the first time. Methods 37 subjects (36 men, mean age 39 ± 16 years, 21 healthy volunteers, 16 patients with suspected coronary artery disease) were included in this study. This preliminary testing stage included mostly men due to more problematic probe fixation in women. All subjects underwent a submaximal exercise stress test on a treadmill (17/37) or bicycle ergometer (11/37). Both sector and matrix probes were used. We assessed semi-quantitatively the quality of acquired apical views at each stage – the four-point grading system was used (0-no view, 1-suboptimal quality, 2-optimal quality, 3-very good quality), 2-3 sufficient for diagnosis. Results The mean time required for careful positioning of the probe and image optimization was 12 ± 3 min and shortened from 13,7 to 11,1 minutes (mean) in first vs second half of the cohort documenting learning curve. At baseline, 9 patients had at least one apical view of quality precluding reliable analysis. Those patients were excluded from further assessment. During stress, 17 patients maintained the optimal or very good quality of all apical views, whereas in 11 patients the quality significantly decreased during the stress test and required probe repositioning. The mean image quality score at baseline was 2,61 ± 0,48 and 2,25 ± 0,6 after exercise. Expectedly, good image quality was easier to obtain and maintain in the supine position (score 2,74 ± 0,44) points as compared with upright position (score 2,25 ± 0,57). Conclusion This preliminary, unique experience with external probe fixation device indicates that continuous acquisition and monitoring of echocardiographic images is feasible during physical exercise, and for the first time ever - also on the treadmill. This feasibility data stem from almost exclusively male patients and the estimated rate of sufficient image quality throughout the entire test is currently around 60%. We are hoping, that gaining more experience with the product could increase the success rate on exercise tests. Abstract P1398 Figure. Treadmill and ergometer stress test

scholarly journals Predictors of deterioration in cardiorespiratory fitness among healthy adults: the importance of sex and obesity

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
A Kaplan ◽  
A Fardman ◽  
S Tiosano ◽  
S Segev ◽  
M Scheinowitz ◽  
...  
Keyword(s):  
Cardiorespiratory Fitness ◽  
Stress Test ◽  
Exercise Stress Test ◽  
Exercise Stress ◽  
Study Endpoint ◽  
Primary Study ◽  
Baseline Visit ◽  
Bruce Protocol ◽  
Study Population ◽  
The Mean

Abstract Introduction Cardiorespiratory fitness (CRF) is associated with cardiovascular co-morbidities and is a strong predictor of adverse cardiovascular outcomes. However, data on the natural history of cardiorespiratory fitness among healthy subjects is limited. Purpose This study investigated what are the predictors of deterioration in CRF over time. Methods We investigated 36,239 men and women who were annually screened in a tertiary medical center and completed an exercise stress test in all visits, with a total of 175,596 annual visits. Subjects who failed to complete maximal exercise stress test according to the Bruce protocol at their first baseline visit were excluded. In addition, subjects with less than five visits to the center or those who developed ischemic heart disease during follow-up were excluded. Fitness was categorized into age- and sex-specific quintiles (Q) according to Bruce protocol treadmill time. Change in CRF between the first baseline visit and the fifth visit was used to calculate fitness deterioration. The primary study endpoint was defined as the lower sex-specific quintile of change in metabolic equivalents (METS) between visits 1 and 5. Logistic regression models were applied. Results Final study population included 10,841 subjects. The mean age of the study population was 49±10 years, the mean BMI was 26±4, and 8107 (75%) were men. Median METS at baseline were 10.8 (IQR 9–12.6) and 11.1 (IQR 9.4–13) at the first and fifth visit, respectively (p<0.001 for METS between visits). Overall, 2189 (20%) subjects met the study endpoint. CFR deterioration was higher among women as compared to men (p=0.023). Out of obesity, hypertension, fasting blood glucose, LDL, and HDL cholesterol, after adjustments for age, sex, and baseline CFR, only obesity was independently associated with fitness deterioration in the multivariate model (OR=1.4 95% CI 1.2–1.5, p<0.001). The association of obesity with fitness deterioration was modified by sex such that the risk of CRF deterioration was more pronounced in women (OR=1.6 95% CI 1.3–2, p<0.001) than in men (OR=1.3 95% CI 1.1–1.4, p<0.001). Conclusion Obesity is an independent predictor of future CRF deterioration. The effect of obesity on future CRF deterioration is more pronounced among women as compared to men. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals P274 Continous echocardiographic monitoring in intensive cardiac care unit with external probe stabilizer - preliminary experience

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
K Wdowiak-Okrojek ◽  
P Lipiec ◽  
J D Kasprzak
Keyword(s):  
External Fixation ◽  
Continuous Monitoring ◽  
Left Ventricular ◽  
Cardiac Care ◽  
Fixation Device ◽  
External Fixation Device ◽  
The Mean ◽  
First Time ◽  
Cardiac Care Unit

Abstract Background The role of transthoracic echocardiography (TTE) in the intensive cardiac care unit is crucial. Imaging is currently performed at the bedside for diagnosis but TTE has also potential to noninvasively provide critical views to assist in patient monitoring. Continuous monitoring would be especially helpful when the patient is unstable; however, continuous availability of skilled sonographers to obtain appropriate views represents a limiting factor. Purpose Recently, an innovative external fixation device allowing prolonged stabilization of transthoracic ultrasound transducer was introduced. The ring-shaped device fitted for TTE probes is attached to the patient by elastic straps to hold the probe in contact with the skin at a fixed but adjustable angle. We developed a research project to assess for the first time the feasibility of continuous TTE imaging with external probe fixation in the intensive cardiac care unit. Methods 12 patients (10 men, mean age 66,5 ± 15 years) hospitalized in intensive cardiac care unit due to cardiac arrest, myocardial infarction, pulmonary embolism, end-stage heart failure or respiratory failure were included in the study. The echocardiographic probe be was fixed in the apical window providing a four-chamber view to monitor left ventricular function. We assessed the patient’s tolerance and comfort as well as the quality of images acquired at baseline and at the end of monitoring. Results Fixation of the probe was successful in all patients (figure 1). The mean time of fixation was 10 ± 1 minute, with a clear learning curve. The quality of obtained images was sufficient for evaluation and was maintained throughout the entire period of monitoring in all patients. Monitoring was stopped at patients’ request when discomfort caused by the compression of the skin by the probe and the fixation device became significant (figure 2). The mean duration of monitoring was 85 + 64 minutes (range 15 to 240 minutes). Conclusions In this preliminary series we have demonstrated for the first time the feasibility of echocardiographic continuous monitoring of patients in the intensive cardiac care unit using TTE probe with the external fixation device. The design of the fixation device opens the evident field for optimization to extend monitoring duration at acceptable levels of discomfort in conscious intensive care patients. We hope the improved version of the fixator will decrease the pressure on the body. Abstract P274 Figure. Fixation of the device

scholarly journals Effects of antioxidant supplementation on oxidative stress balance in young footballers: a randomized controlled trial

2020 ◽  
Author(s):  
Błażej Stankiewicz ◽  
Mirosława Cieślicka ◽  
Sławomir Kujawski ◽  
Elżbieta Piskorska ◽  
Tomasz Kowalik ◽  
...  
Keyword(s):  
Physical Exercise ◽  
Antioxidant Capacity ◽  
Exercise Test ◽  
Controlled Trial ◽  
Stress Test ◽  
Venous Blood ◽  
Exercise Stress Test ◽  
Exercise Stress ◽  
Chokeberry Juice ◽  
Intensive Physical Exercise

Abstract Background The intensive physical exercise in which athletes take part in competitive sports can negatively affect the pro-oxidative–antioxidant balance. The use of compounds with high antioxidant potential, which certainly should include chokeberry, can prevent these adverse changes. Methods The study was conducted on a group of football players aged 16–17 years, who underwent 7 weeks of supplementation with 200 ml chokeberry juice per day. Before and after supplementation, the participants performed an intensive physical exercise test (beep test). At rest, immediately after exercise and after 3 and 24 h of rest, venous blood was taken from the subjects, in which levels of thiobarbituric acid reactive products (TBARS), hydroxy-2'-deoxyguanosine (8-OHdG), total antioxidant capacity (TAC), iron (Fe), hepcidin, ferritin, myoglobin, albumin and morphological parameters were examined. Results There was a significant impact of the intervention in response to the physical exercise test in the studied groups on parameter dynamics: 8-OHdG (t = 3.56, p = 0.0005), albumin (t = 1.98, p = 0.049), TBARS (t = 4.33, p = 0.00003), hepcidin (t = 2.21, p = 0.03), and Mono level (t = 2.14, p = 0.04) and percentage (t = 2.27, p = 0.03). The post-hoc test showed no effect of chokeberry juice supply on any of the morphological, biochemical or performance parameters analysed. Conclusions The supplementation applied to footballers showed no effects under the influence of the applied exercise stress test. Such results may be the result of both the players’ adaptation to the applied exercise loads and the insufficient antioxidant capacity of the supplement used.

scholarly journals Cardiac Rehabilitation and Physical Performance in Patients after Myocardial Infarction: Preliminary Research

2021 ◽  
Vol 10 (11) ◽  
pp. 2253
Author(s):  
Agnieszka Grochulska ◽  
Sebastian Glowinski ◽  
Aleksandra Bryndal
Keyword(s):  
Myocardial Infarction ◽  
Cardiac Rehabilitation ◽  
Physical Performance ◽  
Stress Test ◽  
Maximal Oxygen Consumption ◽  
Exercise Stress Test ◽  
Health Condition ◽  
Exercise Stress ◽  
Test Time ◽  
Before And After

(1) Background: Cardiovascular diseases, in particular, myocardial infarction (MI), are the main threats to human health in modern times. Cardiac rehabilitation (CR), and especially increased physical activity, significantly prevent the consequences of MI. The aim of this study was to assess physical performance in patients after MI before and after CR. (2) Methods: 126 patients after MI were examined. They were admitted to the cardiac rehabilitation ward twice: in the 3rd month after MI, and then in the 6th month after the last rehabilitation session. CR lasted 20 treatment days (4 weeks with 5 treatment days and 2 days’ break). The exercise stress test on the treadmill and a 6-minute walk test (6MWT) were used to assess physical performance. Patients were assigned to an appropriate rehabilitation model due to their health condition. (3) Results: In the studied group, the exercise stress test time and the metabolic equivalent of task (MET), the maximal oxygen consumption (VO2max), and 6MWT score increased significantly (p = 0.0001) at two time-points of observation. (4) Conclusion: CR significantly improves physical performance in patients after MI.

scholarly journals Systolic Blood Pressure Response to Exercise Stress Test and Risk of Stroke

Stroke ◽  
2001 ◽  
Vol 32 (9) ◽  
pp. 2036-2041 ◽  
Author(s):  
S. Kurl ◽  
J.A. Laukkanen ◽  
R. Rauramaa ◽  
T.A. Lakka ◽  
J. Sivenius ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Blood Pressure Response ◽  
Stress Test ◽  
Exercise Stress Test ◽  
Pressure Response ◽  
Exercise Stress ◽  
Response To Exercise

Abstract 15988: Heart Failure Group Medical Visits to Improve Quality of Life: A Feasibility Study

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Iniya Rajendran ◽  
Patricia Williams ◽  
Pei-Chun McGregor
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
High Risk ◽  
Medication Compliance ◽  
Exercise Stress ◽  
Retention Data ◽  
Group Medical Visits ◽  
Medical Visits ◽  
The Mean

Introduction: Group Medical Visits (GMV) are medical appointments where patients with similar medical conditions are seen in a group setting. Heart Failure (HF) is an ideal fit for the GMV model of healthcare delivery. HF guidelines emphasize the need for a self-care regimen including symptom knowledge, medication adherence, dietary and lifestyle modifications and social support. We conducted an intervention with these elements in a GMV setting to assess feasibility and improvement in quality of life (QoL). Methods: We enrolled a convenience sample of high-risk veterans with HF who required frequent follow up. Veterans participated in a longitudinal GMV for eight sessions lasting two hours each and occurring once a month. A curriculum was prepared a priori, and each session was led by an invited guest facilitator and focused on nutrition, exercise, stress, holistic health among others. Feasibility was assessed through recruitment and retention data. We also collected pre-post medication compliance data and QoL change using the 12-item Kansas City Cardiomyopathy Questionnaire (KCCQ-12). We gathered feedback after each session. Results: Twelve patients were invited to the program and nine patients attended the first session. The average attendance was 6 participants each week with 4 participants attending all eight sessions. All were men, 22% identified as Black and 8 of 9 participants had preserved ejection fraction and obesity. At baseline, the mean KCCQ was 49.2. At the end of the intervention, the mean change in KCCQ-12 score was +9 (p=0.39). The largest change (+12, p=0.13) was seen on the QoL subscale. No significant improvement was seen in medication compliance. Participants listed community building, peer to peer education, learning about hospital services and continued contact with their provider as highlights of the program. Due to invitation of high-risk individuals, we had one death and seven hospitalizations during the study period. Conclusions: Longitudinal GMVs for high risk patients has a role in HF education and management. It may improve QoL and provider-patient relationship. It is well accepted by the veteran population and has the potential to be routinely integrated into clinical practice.

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