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Zhang YF, Sun XG, Wang JN, Tai WQ, Zhou QQ, Song Y, Chen JH, Huang J, Jie B, Xu F, Shi C, Liu F, Zhang Y, Li H, Xie YH. [Using changes of left cardiac functional parameters and CPET evaluated the clinical effectiveness of individualized precise exercise overall program management of chronic disease I --Analysis between groups]. Zhongguo Ying Yong Sheng Li Xue Za Zhi 2022; 38:595-603. [PMID: 37308402 DOI: 10.12047/j.cjap.0106.2022.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objective: To explore and study the clinical usefulness of continuous dynamic recording of left cardiac function changes forevaluation the improvement in patients with chronic disease after 3 months of intensive control of individualized precision exercise overall manage program. Methods: From 2018 to 2021, 21 patients with chronic cardiovascular and cerebrovascular metabolic diseases mainly controlled by our team were selected to complete the cardiopulmonary exercise test (CPET) and Non-invasive synchronous cardiac function detector (N-ISCFD), electrocardiogram, radial pulse wave, jugular pulse wave and cardiogram data were continuously recorded for 50s.According to the titration results under CPET and continuous functional parameters monitoring, a holistic plan with individualized moderate exercise intensity as the core was developed for 3 months of intensive management, and then N-ISCFD data collection was repeatedafter signing the informed consent. All N-ISCFD data were analyzed in the 50s according to the optimal report mode of Fuwai Hospital and 52 cardiac functional indexes were calculated. The data before and after the enhanced control were compared and the paired T-test was used to statistically analyze the changes of groups. Results: Twenty-one patients with chronic diseases (16 male and 5 female) were (54.05±12.77,29~75) years, BMI (25.53±4.04,16.62~31.7) kg/m2.Comparison with baseline,the whole group analysis: ①The body weight, BMI, systolic blood pressure and diastolic blood pressure of patients were significantly decreased(P<0.01).②CPET Peak VO2 was (64.93±24.22, 26.96~103.48) %Pred before enhanced control, and (85.22±30.31, 43.95~140.48) %Pred after enhanced control, and increased (35.09±27.87, 0.12~129.35) % after enhanced control compared with before enhanced control. The AT, Peak VO2/HR, Peak Work Rate, OUEP, FVC, FEV1, FEV3/FVC% and MVV were significantly increased (P<0.01) and the Lowest VE/VCO2 and VE/VCO2 Slope were significantly decreased(P<0.01).③Core indicators of left heart function:Ejection fraction was significantly increased from (0.60±0.12,0.40~0.88) to(0.66±0.09, 0.53~0.87)(P< 0.01), by (12.39±14.90,-12.32~41.11)%. The total peripheral resistance was significantly decreased from (1579.52±425.45,779.46~2409.61) G/(cm4·s),to(1340.44±261.49,756.05~1827.01) G/(cm4·s)(P<0.01), by (12.00±17.27,37.79~28.61) %.The left stroke index, cardiac total power, ejective pressure and left ventricular end diastolic volumewere significantly improved (P<0.05).The change analysis of each indicator for each patient is shown in the individualized analysis section of this study. Conclusion: Use CPET and continuous functional monitoring we can safely and effectively develop the overall program of individualized exercise in patients with chronic diseases. Long-term intensive management and control can safely and effectively significantly improve the cardiovascular function of patients. Continuous dynamic recording of changes in left and right cardiac functional parameters can be a simple way to supplement CPET to evaluate cardiovascular function.
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Affiliation(s)
- Yan-Fang Zhang
- The Affiliated Rehabilitation Hospital of Chongqing Medical University, Chongqing 400050
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, National Research Center of Clinical Medicine for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037
| | - Xing-Guo Sun
- The Affiliated Rehabilitation Hospital of Chongqing Medical University, Chongqing 400050
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, National Research Center of Clinical Medicine for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037
| | - Ji-Nan Wang
- The Affiliated Rehabilitation Hospital of Chongqing Medical University, Chongqing 400050
- Peking University Third Hospital, Beijing 100191, China
| | - Wen-Qi Tai
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, National Research Center of Clinical Medicine for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037
| | - Qing-Qing Zhou
- The Affiliated Rehabilitation Hospital of Chongqing Medical University, Chongqing 400050
| | - Ya Song
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, National Research Center of Clinical Medicine for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037
| | - Jia-Hao Chen
- The Affiliated Rehabilitation Hospital of Chongqing Medical University, Chongqing 400050
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, National Research Center of Clinical Medicine for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037
| | - Jiang Huang
- The Affiliated Rehabilitation Hospital of Chongqing Medical University, Chongqing 400050
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, National Research Center of Clinical Medicine for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037
| | - Beng Jie
- The Affiliated Rehabilitation Hospital of Chongqing Medical University, Chongqing 400050
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, National Research Center of Clinical Medicine for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037
| | - Fan Xu
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, National Research Center of Clinical Medicine for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037
| | - Chao Shi
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, National Research Center of Clinical Medicine for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037
| | - Fang Liu
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, National Research Center of Clinical Medicine for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037
| | - Ye Zhang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, National Research Center of Clinical Medicine for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037
| | - Hao Li
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, National Research Center of Clinical Medicine for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037
| | - You-Hong Xie
- The Affiliated Rehabilitation Hospital of Chongqing Medical University, Chongqing 400050
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Hao L, Sun XG, Song Y, Liu F, Tai WQ, Ge WG, Li H, Zhang Y, Chen R, Zou YX, Ma MX, Xia R, Huang Y, Xie YH. [Effect of different work rate increasing rate on the overall function evaluation of cardiopulmonary exercise testing II- sub-peak parameters]. Zhongguo Ying Yong Sheng Li Xue Za Zhi 2021; 37:120-124. [PMID: 34672148 DOI: 10.12047/j.cjap.0084.2021.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Objective: To observe the effect of healthy volunteers different work rate increasing rate cardiopulmonary exercise testing (CPET) on the sub-peak parameters . Methods: Twelve healthy volunteers were randomly assigned to a moderate (30 W/min), a relatively low (10 W/min) and relatively high (60 W/min) three different work rate increasing rate CPET on different working days in a week. The core indicators related to CPET sub-peak exercise of 12 volunteers were compared according to standard Methods: anaerobic threshold (AT), oxygen uptake per unit power (ΔVO2/ΔWR), oxygen uptake eficiency plateau,(OUEP), the lowest average of 90 s of carbon dioxide ventilation equivalent (Lowest VE/ VCO2), the slope of carbon dioxide ventilation equivalent (VE/ VCO2 Slope) and intercept and anaerobic threshold oxygen uptake ventilation efficiency value (VO2/ VE@AT) and the anaerobic threshold carbon dioxide ventilation equivalent value (VE/ VCO2@AT). Paired t test was performed on the difference of each parameter in the three groups of different work rate increasing rate. Results: Compared with the relatively low and relatively high work rate increasing rate group, the moderate work rate increasing rate group uptake eficiency plateau, (42.22±4.76 vs 39.54±3.30 vs 39.29±4.29) and the lowest average of 90 s of carbon dioxide ventilation equivalent (24.13±2.88 vs 25.60±2.08 vs 26.06±3.05) was significantly better, and the difference was statistically significant (P<0.05); Compared with the moderate work rate increasing rate group, the oxygen uptake per unit work rate of the relatively low and relatively high work rate increasing rate group increased and decreased significantly ((8.45±0.66 vs 10.04±0.58 vs 7.16±0.60) ml/(min·kg)), difference of which was statistically significant (P<0.05); the anaerobic threshold did not change significantly ((0.87±0.19 vs 0.87±0.19 vs 0.89±0.19) L/min), the difference was not statistically significant (P>0.05). Conclusion: Relatively low and relatively high power increase rate can significantly change the CPET sub-peak sports related indicators such as the effectiveness of oxygen uptake ventilation, the effectiveness of carbon dioxide exhaust ventilation, and the oxygen uptake per unit work rate. Compared with the moderate work rate increasing rate CPET, the lower and higher work rate increasing rate significantly reduces the effectiveness of oxygen uptake ventilation and the effectiveness of carbon dioxide exhaust ventilation in healthy individuals. The standardized operation of CPET requires the selection of a work rate increasing rate suitable for the subject, so that the CPET sub-peak related indicators can best reflect the true functional state of the subject.
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Affiliation(s)
- Lu Hao
- Fuwai Hospital,Chinese Academy of Medical Sciences/National Center for Cardiovascular Diseases/ State Key Laboratory of Cardiovascular Diseases/Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing 100037
- Henan Provincial People's Hospital,Henan 450003
| | - Xing-Guo Sun
- Fuwai Hospital,Chinese Academy of Medical Sciences/National Center for Cardiovascular Diseases/ State Key Laboratory of Cardiovascular Diseases/Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing 100037
- The Affiliated Rehabilitation Hospital of Chongqing Medical University, Chongqing 400050
| | - Ya Song
- Fuwai Hospital,Chinese Academy of Medical Sciences/National Center for Cardiovascular Diseases/ State Key Laboratory of Cardiovascular Diseases/Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing 100037
- The Affiliated Rehabilitation Hospital of Chongqing Medical University, Chongqing 400050
| | - Fang Liu
- Fuwai Hospital,Chinese Academy of Medical Sciences/National Center for Cardiovascular Diseases/ State Key Laboratory of Cardiovascular Diseases/Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing 100037
| | - Wen-Qi Tai
- Fuwai Hospital,Chinese Academy of Medical Sciences/National Center for Cardiovascular Diseases/ State Key Laboratory of Cardiovascular Diseases/Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing 100037
| | - Wan-Gang Ge
- Fuwai Hospital,Chinese Academy of Medical Sciences/National Center for Cardiovascular Diseases/ State Key Laboratory of Cardiovascular Diseases/Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing 100037
| | - Hao Li
- Fuwai Hospital,Chinese Academy of Medical Sciences/National Center for Cardiovascular Diseases/ State Key Laboratory of Cardiovascular Diseases/Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing 100037
| | - Ye Zhang
- Fuwai Hospital,Chinese Academy of Medical Sciences/National Center for Cardiovascular Diseases/ State Key Laboratory of Cardiovascular Diseases/Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing 100037
| | - Rong Chen
- Fuwai Hospital,Chinese Academy of Medical Sciences/National Center for Cardiovascular Diseases/ State Key Laboratory of Cardiovascular Diseases/Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing 100037
- The Affiliated Rehabilitation Hospital of Chongqing Medical University, Chongqing 400050
| | - Yu-Xin Zou
- Fuwai Hospital,Chinese Academy of Medical Sciences/National Center for Cardiovascular Diseases/ State Key Laboratory of Cardiovascular Diseases/Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing 100037
- Liaocheng People's Hospital, Liaocheng 252000, China
| | - Ming-Xin Ma
- Fuwai Hospital,Chinese Academy of Medical Sciences/National Center for Cardiovascular Diseases/ State Key Laboratory of Cardiovascular Diseases/Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing 100037
- Dalian Children's Hospital,Dalian 116000
| | - Rui Xia
- Fuwai Hospital,Chinese Academy of Medical Sciences/National Center for Cardiovascular Diseases/ State Key Laboratory of Cardiovascular Diseases/Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing 100037
- Dalian Children's Hospital,Dalian 116000
| | - Yan Huang
- Fuwai Hospital,Chinese Academy of Medical Sciences/National Center for Cardiovascular Diseases/ State Key Laboratory of Cardiovascular Diseases/Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing 100037
- Dalian Children's Hospital,Dalian 116000
| | - You-Hong Xie
- The Affiliated Rehabilitation Hospital of Chongqing Medical University, Chongqing 400050
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Ma MX, Sun XG, Zou YX, Yang QZ, Huang Y, Chen R, Tai WQ, Wang JN, Zhou QQ, Liu F, Shi C, Xu F, Zhang Y, Li H, Feng YH, Wang D. [The preliminary report of investigation: Using mask for cardiopulmonary exercise testing in Chinese children may result misinterpretation and misdiagnosis]. Zhongguo Ying Yong Sheng Li Xue Za Zhi 2021; 37:219-224. [PMID: 34672161 DOI: 10.12047/j.cjap.0101.2021.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Objective: Observe the increased anatomical dead space of the mask, summarize the law of exercise induced oscillatory breathing (EIOB) in the results of CPET's new 9 figure, and analyze its incidence and age groups that are prone to oscillatory breathing. Methods: After signed the informed consent form by guardian, 501 children from pre-school to middle-school, aged 3~14 year, performed Harbor-UCLA standard protocol CPET with strict quality control in the CPET laboratory of Liaocheng Children's Hospital since 2014. CPET data was interpreted second by second from the breath by breath collection, averaged by 10s and then display by 9 plots. We analyzed the trends, pattern, incidence and age difference for EIOB and gas leakage. Results: The incidence of EIOB was the highest in the 3 to 6-year-old group, which was 42%. The 7 to 10-year-old group was 29.4% and the 11- to 14-year-old group was 29.9%. The three groups were tested by chi-square (x2=7.512), and the difference was statistically significant (P<0.05). 14 out of 508 children had air leakage during CPET, the incidence rate was 2.7%. Conclusion: The phenomenon of oscillatory breathing (OB) in children may be caused by the increased anatomical dead space of the mask, and it is not caused by disease. To improve the quality of CPET and to reduce clinical misdiagnosis, it is recommended to use a mouthpiece to decrease the dead space rather than the musk.
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Affiliation(s)
- Ming-Xing Ma
- Fuwai Hospital, Chinese Academy of Medical Sciences/National Center for Cardiovascular Diseases/ State Key Laboratory of Cardiovascular Diseases/Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing 100037
- Dalian Children's Hospital of Liaoning Province, Dalian 116000
| | - Xing-Guo Sun
- Fuwai Hospital, Chinese Academy of Medical Sciences/National Center for Cardiovascular Diseases/ State Key Laboratory of Cardiovascular Diseases/Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing 100037
| | - Yu-Xin Zou
- Fuwai Hospital, Chinese Academy of Medical Sciences/National Center for Cardiovascular Diseases/ State Key Laboratory of Cardiovascular Diseases/Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing 100037
- Children's Hospital of Liaocheng Municipal Hospital of Shandong Province, Liaocheng 252000
| | - Qiao-Zhi Yang
- Children's Hospital of Liaocheng Municipal Hospital of Shandong Province, Liaocheng 252000
| | - Yan Huang
- Fuwai Hospital, Chinese Academy of Medical Sciences/National Center for Cardiovascular Diseases/ State Key Laboratory of Cardiovascular Diseases/Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing 100037
- Dalian Children's Hospital of Liaoning Province, Dalian 116000
- Chinese Academy of Sciences University School of Medicine, Beijing 100037
| | - Rong Chen
- Fuwai Hospital, Chinese Academy of Medical Sciences/National Center for Cardiovascular Diseases/ State Key Laboratory of Cardiovascular Diseases/Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing 100037
- Dalian Children's Hospital of Liaoning Province, Dalian 116000
| | - Wen-Qi Tai
- Fuwai Hospital, Chinese Academy of Medical Sciences/National Center for Cardiovascular Diseases/ State Key Laboratory of Cardiovascular Diseases/Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing 100037
| | - Ji-Nan Wang
- Fuwai Hospital, Chinese Academy of Medical Sciences/National Center for Cardiovascular Diseases/ State Key Laboratory of Cardiovascular Diseases/Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing 100037
| | - Qing-Qing Zhou
- Fuwai Hospital, Chinese Academy of Medical Sciences/National Center for Cardiovascular Diseases/ State Key Laboratory of Cardiovascular Diseases/Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing 100037
| | - Fang Liu
- Fuwai Hospital, Chinese Academy of Medical Sciences/National Center for Cardiovascular Diseases/ State Key Laboratory of Cardiovascular Diseases/Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing 100037
| | - Chao Shi
- Fuwai Hospital, Chinese Academy of Medical Sciences/National Center for Cardiovascular Diseases/ State Key Laboratory of Cardiovascular Diseases/Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing 100037
| | - Fan Xu
- Fuwai Hospital, Chinese Academy of Medical Sciences/National Center for Cardiovascular Diseases/ State Key Laboratory of Cardiovascular Diseases/Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing 100037
| | - Ye Zhang
- Fuwai Hospital, Chinese Academy of Medical Sciences/National Center for Cardiovascular Diseases/ State Key Laboratory of Cardiovascular Diseases/Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing 100037
| | - Hao Li
- Fuwai Hospital, Chinese Academy of Medical Sciences/National Center for Cardiovascular Diseases/ State Key Laboratory of Cardiovascular Diseases/Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing 100037
| | - Yun-Hong Feng
- Fuwai Hospital, Chinese Academy of Medical Sciences/National Center for Cardiovascular Diseases/ State Key Laboratory of Cardiovascular Diseases/Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing 100037
- The People's Hospital of Rugao City, Rugao 226500, China
| | - Dong Wang
- Fuwai Hospital, Chinese Academy of Medical Sciences/National Center for Cardiovascular Diseases/ State Key Laboratory of Cardiovascular Diseases/Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing 100037
- The People's Hospital of Rugao City, Rugao 226500, China
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Li HM, Sun XG, Tai WQ, Song Y, Hao L, Zhang Y, Liu F, Wang JN, Zhou QQ, Xu DD, Xu F, Shi C. [The new theory CPET guides the overall plan of individualized precision exercise to effectively improve the overall functional status of "frailty"]. Zhongguo Ying Yong Sheng Li Xue Za Zhi 2021; 37:208-218. [PMID: 34672160 DOI: 10.12047/j.cjap.0098.2021.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Objective: Under the guidance of the new theory of holistic integrated physiology and medicine, the effect of individualized accurate exercise program on the overall functional state was studied according to cardiopulmonary exercise testing (CPET). Methods: Li xx, female, 31 years old, has a fast heart rate since childhood (90~100 bpm), usually feel cold, especially in autumn and winter, and general health good. CPET was performed after signing the informed consent form at Fuwai Hospital in September 2019. Peak oxygen uptake, anaerobic threshold (AT), and peak cardiac output were (69~72)% pred, respectively, and the oxygen uptake ventilation efficiency and carbon dioxide exhaust ventilation efficiency were basically normal (96~100)% pred. The resting heart rate was fast, the blood pressure was low, the blood pressure response was weak during exercise, and the heart rate was mainly increased. The holistic integrated physiology medical theory pointed out that she was in weak health and heart weakness was the main manifestation. CPET was used to guide individualized precise exercise intensity titration, combine continuous beat-by-beat blood pressure, ECG, pulse and blood glucose dynamic monitoring to formulate an holisticplan of individualized quantitative exercise .Reexamine CPET after 8 weeks' strengthening management. Results: After 8 weeks of intensive holistic management, the limbs were warm and the cold symptoms disappeared. Re-examination of CPET peak oxygen uptake, AT and peak cardiac output were (90~98)% pred, which increased by (30~36)% respectively, and the holistic weak functional status was significantly improved; basically normal oxygen uptake ventilation efficiency and carbon dioxide exhaust ventilation efficiency also increased by (10~37)% respectively; resting heart rate and blood pressure basically returned to normal, and blood pressure and heart rate response during exercise were normal. Continuous ambulatory blood glucose monitoring indicated that the average blood glucose level decreased slightly and became more stable. Repeated measurement results of continuous ECG and beat-to-beat blood pressure also indicated a decrease in heart rate and an increase in blood pressure during rest, exercise and during sleep, and radial pulse wave. The amplitude of the dicrotic wave increases and becomes more pronounced. Conclusion: The new theoretical system to guide CPET to formulate an holistic plan for individualized precision exercise can safely and effectively enhance myocardial contractility, increase stroke volume, increase blood pressure, lower heart rate, stabilize and slightly lower blood glucose, and improve holistic functional status.
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Affiliation(s)
- Hui-Min Li
- Department of Cardiology,Fuwai Hospital,Chinese Academy of Medical Sciences/National Center for Cardiovascular Diseases/ State Key Laboratory of Cardiovascular Diseases/Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing 100037
- Ganzhou People's Hospital, Ganzhou 341000
| | - Xing-Guo Sun
- Department of Cardiology,Fuwai Hospital,Chinese Academy of Medical Sciences/National Center for Cardiovascular Diseases/ State Key Laboratory of Cardiovascular Diseases/Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing 100037
- Rehabilitation Hospital Affiliated to Chongqing Medical University, Chongqing 400000
| | - Wen-Qi Tai
- Department of Cardiology,Fuwai Hospital,Chinese Academy of Medical Sciences/National Center for Cardiovascular Diseases/ State Key Laboratory of Cardiovascular Diseases/Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing 100037
| | - Ya Song
- Department of Cardiology,Fuwai Hospital,Chinese Academy of Medical Sciences/National Center for Cardiovascular Diseases/ State Key Laboratory of Cardiovascular Diseases/Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing 100037
- Rehabilitation Hospital Affiliated to Chongqing Medical University, Chongqing 400000
| | - Lu Hao
- Department of Cardiology,Fuwai Hospital,Chinese Academy of Medical Sciences/National Center for Cardiovascular Diseases/ State Key Laboratory of Cardiovascular Diseases/Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing 100037
- Rehabilitation Hospital Affiliated to Chongqing Medical University, Chongqing 400000
| | - Ye Zhang
- Department of Cardiology,Fuwai Hospital,Chinese Academy of Medical Sciences/National Center for Cardiovascular Diseases/ State Key Laboratory of Cardiovascular Diseases/Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing 100037
| | - Fang Liu
- Department of Cardiology,Fuwai Hospital,Chinese Academy of Medical Sciences/National Center for Cardiovascular Diseases/ State Key Laboratory of Cardiovascular Diseases/Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing 100037
| | - Ji-Nan Wang
- Department of Cardiology,Fuwai Hospital,Chinese Academy of Medical Sciences/National Center for Cardiovascular Diseases/ State Key Laboratory of Cardiovascular Diseases/Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing 100037
- Rehabilitation Hospital Affiliated to Chongqing Medical University, Chongqing 400000
| | - Qing-Qing Zhou
- Department of Cardiology,Fuwai Hospital,Chinese Academy of Medical Sciences/National Center for Cardiovascular Diseases/ State Key Laboratory of Cardiovascular Diseases/Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing 100037
- Rehabilitation Hospital Affiliated to Chongqing Medical University, Chongqing 400000
| | - Dan-Dan Xu
- Hubei Hospital of Traditional Chinese Medicine, Wuhan 430000, China
| | - Fan Xu
- Department of Cardiology,Fuwai Hospital,Chinese Academy of Medical Sciences/National Center for Cardiovascular Diseases/ State Key Laboratory of Cardiovascular Diseases/Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing 100037
| | - Chao Shi
- Department of Cardiology,Fuwai Hospital,Chinese Academy of Medical Sciences/National Center for Cardiovascular Diseases/ State Key Laboratory of Cardiovascular Diseases/Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing 100037
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Song Y, Sun XG, Xie YH, Tai WQ, Wang JN, Zhang Y, Zhang YF, Shi C, He LL, Hao L, Liu F, Feng J, Zhang ZY, Liu YL, Yu H. [Cardiopulmonary exercise testing (CPET)to evaluate the efficacy after intensive control of personalized precise exercise training for cardiovascular and cerebrovascular chronic diseases]. Zhongguo Ying Yong Sheng Li Xue Za Zhi 2021; 37:79-88. [PMID: 34672467 DOI: 10.12047/j.cjap.0092.2021.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Objective: To study the symptom-restricted extreme cardiopulmonary exercise testing (CPET) to evaluate the improvement of the overall function of patients with long-term chronic diseases after intensive control of personalized precise exercise training for 3 months. Methods: We selected 20 patients with chronic cardiovascular and cerebrovascular metabolic diseases who were intensively controlled by our team from 2014 to 2016. After signing the informed consent form, based on the results of CPET and continuous functional tests, we formulated the overall management plan with individualized moderate exercise intensity as the core. After 3 months, CPET was performed. The changes of CPET indicators before and after intensive control in each patient were analyzed individually. Then the difference value and percentage difference value were calculated. Results: In this study, 20 patients (18 males and 2 females) with chronic cardiovascular and cerebrovascular metabolic diseases, aged (55.75±10.80, 26~73) years, height (172.20±8.63, 153~190) cm, weight (76.35±15.63, 53~105) kg, all patients were not any dangerous events during the period of CPET and intensive control.①After intensive control, the static pulmonary function index, resting systolic blood pressure, rate blood pressure product and fasting blood glucose were significantly improved (P<0.05).②Before intensive control, the peak oxygen uptake is (55.60±15.69, 34.37~77.45) % pred and anaerobic threshold is (60.11±12.26, 43.29~80.63)% pred; after intensive control, the peak oxygen uptake is (71.85±21.04, 42.40~102.00) % pred and anaerobic threshold (74.95±17.03, 51.90~99.47) %pred. Compared with before the intensive control, the peak oxygen uptake and anaerobic threshold of all patients after intensive control were significantly increased by (29.09±7.38,17.78~41.80) % and(25.16±18.38, 1.77~81.86)%(all P<0.01). Other core indexes were also improved significantly, including peak oxygen uptake,peak heart rate, peak work rate, oxygen uptake efficiency plateau, lowest value of carbon dioxide ventilatory efficiency, slope of ventilatory equivalent for carbon dioxide, ramp exercise duration(all P<0.01).③In terms of individualized analysis, after intensive control, the above 8 CPET core indexes were all improved in 15 cases, and 7 indexes in 5 cases were improved; the peak oxygen uptakeof all cases increased by more than 15%, 16 cases > 20%, 13 cases > 25%, 10 cases > 30%. Conclusion: CPET can safely, objectively and quantitatively evaluate the overall functional status and therapeutic effects, and guide the formulation of individualized precise exercise intensity. The overall plan of individualized precision exercise for three months can safely and effectively reverse the overall functional status of patients with long-term cardio-cerebrovascular metabolism diseases.
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Affiliation(s)
- Ya Song
- 1. National Center for Cardiovascular Diseases, Fuwai Hospital,Chinese Academy of Medical Sciences, Peking Union Medical College, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Diseases, Beijing 100037
- 2. The Affiliated Rehabilitation Hospital of Chongqing Medical University, Chongqing 400000
- 3. Beijing Rehabilitation Hospital, Beijing 100144, China
| | - Xing-Guo Sun
- 1. National Center for Cardiovascular Diseases, Fuwai Hospital,Chinese Academy of Medical Sciences, Peking Union Medical College, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Diseases, Beijing 100037
- 2. The Affiliated Rehabilitation Hospital of Chongqing Medical University, Chongqing 400000
- 3. Beijing Rehabilitation Hospital, Beijing 100144, China
| | - You-Hong Xie
- 1. National Center for Cardiovascular Diseases, Fuwai Hospital,Chinese Academy of Medical Sciences, Peking Union Medical College, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Diseases, Beijing 100037
- 2. The Affiliated Rehabilitation Hospital of Chongqing Medical University, Chongqing 400000
- 3. Beijing Rehabilitation Hospital, Beijing 100144, China
| | - Wen-Qi Tai
- 1. National Center for Cardiovascular Diseases, Fuwai Hospital,Chinese Academy of Medical Sciences, Peking Union Medical College, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Diseases, Beijing 100037
- 2. The Affiliated Rehabilitation Hospital of Chongqing Medical University, Chongqing 400000
- 3. Beijing Rehabilitation Hospital, Beijing 100144, China
| | - Ji-Nan Wang
- 1. National Center for Cardiovascular Diseases, Fuwai Hospital,Chinese Academy of Medical Sciences, Peking Union Medical College, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Diseases, Beijing 100037
- 2. The Affiliated Rehabilitation Hospital of Chongqing Medical University, Chongqing 400000
- 3. Beijing Rehabilitation Hospital, Beijing 100144, China
| | - Ye Zhang
- 1. National Center for Cardiovascular Diseases, Fuwai Hospital,Chinese Academy of Medical Sciences, Peking Union Medical College, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Diseases, Beijing 100037
- 2. The Affiliated Rehabilitation Hospital of Chongqing Medical University, Chongqing 400000
- 3. Beijing Rehabilitation Hospital, Beijing 100144, China
| | - Yan-Fang Zhang
- 1. National Center for Cardiovascular Diseases, Fuwai Hospital,Chinese Academy of Medical Sciences, Peking Union Medical College, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Diseases, Beijing 100037
- 2. The Affiliated Rehabilitation Hospital of Chongqing Medical University, Chongqing 400000
- 3. Beijing Rehabilitation Hospital, Beijing 100144, China
| | - Chao Shi
- 1. National Center for Cardiovascular Diseases, Fuwai Hospital,Chinese Academy of Medical Sciences, Peking Union Medical College, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Diseases, Beijing 100037
- 2. The Affiliated Rehabilitation Hospital of Chongqing Medical University, Chongqing 400000
- 3. Beijing Rehabilitation Hospital, Beijing 100144, China
| | - Long-Lin He
- 1. National Center for Cardiovascular Diseases, Fuwai Hospital,Chinese Academy of Medical Sciences, Peking Union Medical College, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Diseases, Beijing 100037
- 2. The Affiliated Rehabilitation Hospital of Chongqing Medical University, Chongqing 400000
- 3. Beijing Rehabilitation Hospital, Beijing 100144, China
| | - Lu Hao
- 1. National Center for Cardiovascular Diseases, Fuwai Hospital,Chinese Academy of Medical Sciences, Peking Union Medical College, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Diseases, Beijing 100037
- 2. The Affiliated Rehabilitation Hospital of Chongqing Medical University, Chongqing 400000
- 3. Beijing Rehabilitation Hospital, Beijing 100144, China
| | - Fang Liu
- 1. National Center for Cardiovascular Diseases, Fuwai Hospital,Chinese Academy of Medical Sciences, Peking Union Medical College, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Diseases, Beijing 100037
- 2. The Affiliated Rehabilitation Hospital of Chongqing Medical University, Chongqing 400000
- 3. Beijing Rehabilitation Hospital, Beijing 100144, China
| | - Jing Feng
- 1. National Center for Cardiovascular Diseases, Fuwai Hospital,Chinese Academy of Medical Sciences, Peking Union Medical College, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Diseases, Beijing 100037
- 2. The Affiliated Rehabilitation Hospital of Chongqing Medical University, Chongqing 400000
- 3. Beijing Rehabilitation Hospital, Beijing 100144, China
| | - Zhen-Ying Zhang
- 1. National Center for Cardiovascular Diseases, Fuwai Hospital,Chinese Academy of Medical Sciences, Peking Union Medical College, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Diseases, Beijing 100037
- 2. The Affiliated Rehabilitation Hospital of Chongqing Medical University, Chongqing 400000
- 3. Beijing Rehabilitation Hospital, Beijing 100144, China
| | - Yan-Ling Liu
- 1. National Center for Cardiovascular Diseases, Fuwai Hospital,Chinese Academy of Medical Sciences, Peking Union Medical College, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Diseases, Beijing 100037
- 2. The Affiliated Rehabilitation Hospital of Chongqing Medical University, Chongqing 400000
- 3. Beijing Rehabilitation Hospital, Beijing 100144, China
| | - Hong Yu
- 1. National Center for Cardiovascular Diseases, Fuwai Hospital,Chinese Academy of Medical Sciences, Peking Union Medical College, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Diseases, Beijing 100037
- 2. The Affiliated Rehabilitation Hospital of Chongqing Medical University, Chongqing 400000
- 3. Beijing Rehabilitation Hospital, Beijing 100144, China
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