ISSN:0883-9212    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:0883-9212    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

PURPOSE:Smoking cessation is an important goal for smokers with coronary artery disease (CAD) because it reduces cardiac morbidity and mortality. Effective interventions for cigarette smokers with CAD exist, but they often are considered to be intensive and expensive. Steppedcare interventions have been proposed as a promising way to allocate smoking cessation treatments in a cost‐effective manner. Stepped care refers to the practice of initiating treatment with low‐intensity intervention and then exposing treatment failures to successively more intense interventions.METHODS:To address the efficacy of this approach, 254 cigarette smokers hospitalized with CAD were provided a brief cessation intervention. The participants then were assigned randomly to either a more intensive stepped‐care treatment (counseling and nicotine patch therapy) or no additional treatment. Outcomes were point‐prevalent abstinence measured 3 months and 1 year after hospital discharge.RESULTS:Stepped‐care treatment increased smoking cessation rates from 42% to 53% during a 3‐month follow‐up period (P= .05), but showed little effect at the 1‐year follow‐up assessment, as evidenced by a cessation rate for the minimal intervention group of 36% versus 39% for the stepped‐care group (P= .36).CONCLUSIONS:A stepped‐care approach to smoking cessation increased short‐ but not long‐term point‐prevalent abstinence in patients with CAD. For improvement of long‐term effectiveness, refinement of the timing and content of stepped‐care interventions needs to occur.

ISSN:0883-9212    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

PURPOSE:A significant discrepancy between measured oxygen consumption (VO2) (via ventilatory expired gas analysis) and estimated VO2(via the imposed workload) frequently is reported in the heart failure (HF) population during symptom‐limited exercise testing. The purpose of this investigation was to examine the difference between measured and estimated VO2(VO2discrepancy) during a highly conservative ramping protocol.METHODS:For this study, 28 subjects with compensated HF (20 men and 8 women; age, 51.1 ± 14.6 years) and 19 healthy control subjects (age‐, gender‐, and activity‐matched to an HF subgroup) underwent symptom‐limited exercise testing (treadmill) with ventilatory expired gas analysis.RESULTS:Peak estimated and measured VO2values were significantly higher in the age‐, gender‐, and activity‐matched control group than in the HF group, but the change in measured VO2per change in estimated VO2(&Dgr;measured/&Dgr;estimated VO2slope) and the VO2discrepancy did not reach statistical significance. Peak estimated VO2was a significant predictor of peak measured VO2in the overall HF group (R2= 0.90;P< .001).CONCLUSIONS:Although estimated VO2is not considered a replacement for measured VO2, these results indicate that a highly conservative exercise protocol may allow for a more accurate prediction of peak measured VO2via the estimated oxygen cost for a given workload in patients with compensated HF.

ISSN:0883-9212    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:0883-9212    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

PURPOSE:The aim of this study was to investigate training and detraining effects on blood lipids and apolipoproteins induced by a specific program that combined strength and aerobic exercise in patients with coronary artery disease (CAD).METHODS:For this study, 14 patients participated in a supervised 8‐month training program composed of two strength sessions (60% of 1 repetition maximum) and two aerobic training sessions (60%‐85% of maximum heart rate), and 13 patients served as a control group. Blood samples for total cholesterol (TC), triglycerides (TG), high‐density lipoprotein cholesterol (HDL‐C), apolipoproteins A1 (apo‐A1) and B (apo‐B), and lipoprotein (a) (Lp[a]) were obtained along with muscular strength at the beginning of the study, after 4 and 8 months of training and after 3 months of detraining.RESULTS:The patients in the intervention group showed favorable alterations after 8 months of training (TC, −9.4; TG, −18.6; HDL‐C, 5.2; apo‐A1, 11.2%;P< .05), but these were reversed after 3 months of detraining (TC, +3.7; TG, 16.1; HDL‐C, −3.6; apo‐A1, −5.5%). In addition, body strength also improved after training (27.8%) but reversed (−12.9%) after detraining (P< .05). The patients in the control group did not experience any significant alterations.CONCLUSIONS:The results indicate that an 8‐month training program combining strength and aerobic exercise induces favorable muscular and biochemical adaptations, on TC, TG, HDL‐C, and apo‐A1 levels, protecting patients with CAD. After 3 months of detraining, however, the favorable adaptations were reversed, underscoring the need of uninterrupted exercise throughout life.

ISSN:0883-9212    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:0883-9212    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:0883-9212    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:0883-9212    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

PURPOSE:This study aimed to compare the metabolic, ventilatory, and dyspnea responses to unsupported arm exercise, supported arm exercise and leg exercise between subjects with chronic obstructive pulmonary disease (COPD) and healthy age‐matched controls.METHODS:For this study, 21 subjects with COPD (mean age, 62 ± 2 years; predicted forced expiratory volume in 1 second [FEV1], 37 ± 3%) and 7 healthy age‐matched control subjects (% pred FEV1= 109 ± 5%) were included in the analyses of three incremental exercise tests to peak work capacity: unsupported arm exercise, supported arm exercise (arm ergometry), and leg exercise (cycle ergometry). Work level, oxygen consumption (VO2), minute ventilation (VE), dyspnea, and rate of perceived exertion were measured each minute.RESULTS:Peak work level and peak VO2were significantly reduced in the subjects with COPD for all exercise tests (P< .01 for all), as compared with the control subjects. Within the COPD group, the VO2and VEat peak exercise were significantly lower for unsupported arm exercise than for both the leg and supported arm exercises (bothP< .001). The ratio of VEto maximal voluntary ventilation was high for leg exercise (96%), supported arm exercise (91%), and unsupported arm exercise (77%) among the subjects with COPD. At a given percentage of VO2peak, dyspnea scores were similar for all the exercise tests.CONCLUSIONS:Ventilatory constraints limit exercise performance in COPD. The lowest amount of work, in terms of VO2,, was during unsupported arm exercise. Because the subjects with COPD had scores showing similar levels of dyspnea at the same percentage of VO2peak, it is suggested that patients be encouraged to reach equivalent dyspnea levels when performing unsupported and supported arm exercise training and leg training.

ISSN:0883-9212    

出版商:OVID    

年代:2003

数据来源: OVID