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Spicer MG, Dennis AT. Perioperative Exercise Testing in Pregnant and Non-Pregnant Women of Reproductive Age: A Systematic Review. J Clin Med 2024; 13:416. [PMID: 38256550 PMCID: PMC10816516 DOI: 10.3390/jcm13020416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/05/2024] [Accepted: 01/08/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Women have classically been excluded from the development of normal data and reference ranges, with pregnant women experiencing further neglect. The incidence of Caesarean section in pregnant women, and of general operative management in young women (both pregnant and non-pregnant), necessitates the formal development of healthy baseline data in these cohorts to optimise their perioperative management. This systematic review assesses the representation of young women in existing reference ranges for several functional exercise tests in common use to facilitate functional assessment in this cohort. METHODS Existing reference range data for the exercise tests the Six Minute Walk Test (6MWT), the Incremental Shuttle Walk Test (ISWT) and Cardiopulmonary Exercise Testing (CPET) in young women of reproductive age were assessed using the MEDLINE (Ovid) database, last searched December 2023. Results were comparatively tabulated but not statistically analysed given underlying variances in data. RESULTS The role of exercise testing in the perioperative period as an assessment tool, as well as its safety during pregnancy, was evaluated using 65 studies which met inclusion criteria. CONCLUSION There is a significant lack of baseline data regarding these tests in this population, especially amongst the pregnant cohort, which limits the application of exercise testing clinically.
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Affiliation(s)
- Madeleine G. Spicer
- Department of Obstetrics and Gynaecology, Alice Springs Hospital, Alice Springs, NT 0870, Australia
| | - Alicia T. Dennis
- Department of Anaesthesia, Pain and Perioperative Medicine, Joan Kirner Women’s and Children’s Hospital, Western Health, St Albans, VIC 3021, Australia;
- School of Medicine, Faculty of Health, Deakin University, Melbourne, VIC 3125, Australia
- Departments of Critical Care, Obstetrics and Gynaecology, University of Melbourne, Melbourne, VIC 3010, Australia
- Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
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Skare Ø, Mamen A, Skogstad M. The COVID-19 Pandemic Decreases Cardiorespiratory Fitness: A 3-Year Follow-Up Study in Industry. J Cardiovasc Dev Dis 2023; 11:9. [PMID: 38248879 PMCID: PMC10816953 DOI: 10.3390/jcdd11010009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 12/16/2023] [Accepted: 12/27/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND We aimed to determine if maximal oxygen uptake (V˙O2max), resting heart rate (RHR), and self-reported leisure- time moderate to vigorous physical activity (MVPA) changed over a 3-year follow-up (FU) among industrial workers. METHODS We assessed cardiorespiratory fitness (CRF) August 2018 and August 2021. The last 17-18 months coincided with the COVID-19 pandemic. Data from 86 participants were collected; demographics by questionnaire and cardiovascular outcomes from medical examination: V˙O2max, RHR, and fat mass (%). Workers reported on their leisure-time MVPA twice. To assess changes in health outcomes we applied a linear mixed model, adjusting for baseline (BL) age, sex, pack-years, shift work, and a 5-month plant shutdown. Further, we adjusted for actual age instead of BL age. RESULTS V˙O2max decreased from 39.6 mL/kg/min at BL to 34.0 at FU, a reduction of 5.6 mL/kg/min (95%CI, -7.6, -3.7). Adjusted for actual age, the corresponding figure for V˙O2max was 5.4 mL/kg/min, (95%CI, -7.4, -3.4), an annual loss of 4.6%. RHR increased from 61.3 to 64.4 beats per minute (95%CI, 0.8, 5.4). Self-reported MVPA decreased by 43.9 min/week, (95%CI, -73.5, -14.4). CONCLUSIONS We observed a decrease in V˙O2max, an increase in RHR and a decrease in self-reported MVPA, suggesting physical inactivity during the COVID-19 pandemic.
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Affiliation(s)
- Øivind Skare
- National Institute of Occupational Health (STAMI), Box 5330 Majorstuen, 0304 Oslo, Norway
| | - Asgeir Mamen
- School of health Sciences, Kristiania University College, Box 1190 Sentrum, 0107 Oslo, Norway;
| | - Marit Skogstad
- National Institute of Occupational Health (STAMI), Box 5330 Majorstuen, 0304 Oslo, Norway
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Letnes JM, Nes BM, Wisløff U. Age-related decline in peak oxygen uptake: Cross-sectional vs. longitudinal findings. A review. INTERNATIONAL JOURNAL OF CARDIOLOGY. CARDIOVASCULAR RISK AND PREVENTION 2023; 16:200171. [PMID: 36874046 PMCID: PMC9975246 DOI: 10.1016/j.ijcrp.2023.200171] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/09/2023] [Accepted: 01/12/2023] [Indexed: 01/15/2023]
Abstract
Cardiorespiratory fitness is established as an important prognostic factor for cardiovascular and general health. In clinical settings cardiorespiratory fitness is often measured by cardiopulmonary exercise testing determining the gold-standard peak oxygen uptake (VO2peak). Due to the considerable impact of age and sex on VO2peak, results from cardiopulmonary exercise testing are typically assessed in the context of age- and sex-specific reference values, and multiple studies have been conducted establishing reference materials by age and sex using cross-sectional designs. However, crossectional and longitudinal studies have shown somewhat conflicting results regarding age-related declines of VO2peak, with larger declines reported in longitudinal studies. In this brief review, we compare findings from crossectional and longitudinal studies on age-related trajectories in VO2peak to highlight differences in these estimates which should be acknowledged when clinicians interpret VO2peak measurements repeated over time.
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Affiliation(s)
- Jon Magne Letnes
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.,Clinic of Cardiology, St. Olavs University Hospital, Trondheim, Norway
| | - Bjarne M Nes
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.,Clinic of Cardiology, St. Olavs University Hospital, Trondheim, Norway
| | - Ulrik Wisløff
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.,School of Human Movement and Nutrition Science, University of Queensland, Queensland, Australia
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Triantafyllidi H, Benas D, Iliodromitis E. Cardiopulmonary exercise testing: Is it time to be included in a routine checkup for a relatively healthy population? Int J Cardiol 2023; 373:81-82. [PMID: 36423690 DOI: 10.1016/j.ijcard.2022.11.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 11/18/2022] [Indexed: 11/23/2022]
Affiliation(s)
- Helen Triantafyllidi
- 2(nd) Department of Cardiology, Medical School, National and Kapodistrian University of Athens, ATTIKON Hospital, Athens, Greece.
| | - Dimitrios Benas
- 2(nd) Department of Cardiology, Medical School, National and Kapodistrian University of Athens, ATTIKON Hospital, Athens, Greece
| | - Efstathios Iliodromitis
- 2(nd) Department of Cardiology, Medical School, National and Kapodistrian University of Athens, ATTIKON Hospital, Athens, Greece
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Kaminsky LA, Arena R, Myers J, Peterman JE, Bonikowske AR, Harber MP, Medina Inojosa JR, Lavie CJ, Squires RW. Updated Reference Standards for Cardiorespiratory Fitness Measured with Cardiopulmonary Exercise Testing: Data from the Fitness Registry and the Importance of Exercise National Database (FRIEND). Mayo Clin Proc 2022; 97:285-293. [PMID: 34809986 DOI: 10.1016/j.mayocp.2021.08.020] [Citation(s) in RCA: 45] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 08/26/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To provide updated reference standards for cardiorespiratory fitness (CRF) for the United States derived from cardiopulmonary exercise (CPX) testing when using a treadmill or cycle ergometer. PATIENTS AND METHODS Thirty-four laboratories in the United States contributed data to the Fitness Registry and the Importance of Exercise National Database. Analysis included 22,379 tests (16,278 treadmill and 6101 cycle ergometer) conducted between January 1, 1968, through March 31, 2021, from apparently healthy adults (aged 20 to 89 years). Percentiles of peak oxygen consumption for men and women were determined for each decade from 20 through 89 years of age for treadmill and cycle exercise modes, as well as when defining maximal effort as respiratory exchange ratio (RER) greater than or equal to 1.0 or RER greater than or equal to 1.1. RESULTS For both men and women, the 50th percentile scores for each exercise mode decreased with age and were higher in men across all age groups and higher for treadmill compared with cycle CPX. The average rate of decline per decade over a 6-decade period was 13.5%, 4.0 mLO2·kg-1·min-1 for treadmill CPX and 16.4%, 4.3 mLO2·kg-1·min-1 for cycle CPX. Observationally, the mean peak oxygen consumption was similar whether using an RER criterion of greater than or equal to 1.0 or greater than or equal to 1.1 across the different test modes, ages, and for both sexes. The updated reference standards for treadmill CPX were 1.5 - 4.6 mLO2·kg-1·min-1 lower compared with the previous 2015 standards whereas the updated cycling standards were generally comparable to the original 2017 standards. CONCLUSION These updated cardiorespiratory fitness reference standards improve the representativeness of the US population compared with the original standards.
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Affiliation(s)
- Leonard A Kaminsky
- Fisher Institute for Health and Well-Being, College of Health, Ball State University, Muncie, IN, USA; Clinical Exercise Physiology Laboratory, College of Health, Ball State University, Muncie, IN, USA; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA.
| | - Ross Arena
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA; Department of Physical Therapy, College of Applied Science, University of Illinois at Chicago, Chicago, IL, USA
| | - Jonathan Myers
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA; Division of Cardiology, Veterans Affairs Palo Alto Healthcare System and Stanford University, Palo Alto, CA, USA
| | - James E Peterman
- Fisher Institute for Health and Well-Being, College of Health, Ball State University, Muncie, IN, USA; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA
| | - Amanda R Bonikowske
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Matthew P Harber
- Clinical Exercise Physiology Laboratory, College of Health, Ball State University, Muncie, IN, USA
| | - Jose R Medina Inojosa
- Marriott Heart Disease Research Program, Mayo Clinic, Rochester, MN, USA; John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, LA, USA
| | - Carl J Lavie
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, LA, USA
| | - Ray W Squires
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
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Triantafyllidi H, Birmpa D, Benas D, Trivilou P, Fambri A, Iliodromitis EK. Cardiopulmonary exercise testing: The ABC for the Clinical Cardiologist. Cardiology 2021; 147:62-71. [PMID: 34649252 DOI: 10.1159/000520024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 10/04/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Helen Triantafyllidi
- 2nd Department of Cardiology, National and Kapodistrian University of Athens, Medical School, ATTIKON Hospital, Athens, Greece
| | - Dionyssia Birmpa
- 2nd Department of Cardiology, National and Kapodistrian University of Athens, Medical School, ATTIKON Hospital, Athens, Greece
| | - Dimitrios Benas
- 2nd Department of Cardiology, National and Kapodistrian University of Athens, Medical School, ATTIKON Hospital, Athens, Greece
| | - Paraskevi Trivilou
- 2nd Department of Cardiology, National and Kapodistrian University of Athens, Medical School, ATTIKON Hospital, Athens, Greece
| | - Anastasia Fambri
- 2nd Department of Cardiology, National and Kapodistrian University of Athens, Medical School, ATTIKON Hospital, Athens, Greece
| | - Efstathios K Iliodromitis
- 2nd Department of Cardiology, National and Kapodistrian University of Athens, Medical School, ATTIKON Hospital, Athens, Greece
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