ISSN:0883-9212    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

PURPOSEThe clinical phase of chronic heart failure (HF) includes a marked decline in exercise tolerance, in part due to impaired skeletal muscle blood flow delivery. Interestingly, the role of the venous system on exercise tolerance in patients with HF has not received much attention, despite evidence of changes in venous structure and function. The purpose of this study was to examine the relationship between forearm arterial and venous function, and exercise tolerance in patients with HF and age-matched controls.METHODSVascular function and exercise tolerance was examined in 20 patients with HF (age 59 ± 13 years) and 10 control subjects (age 51 ± 16 years). Nondominant forearm arterial inflow, vascular resistance, venous capacitance, and venous outflow were evaluated at rest and after 5 minutes of upper arm occlusion, using strain gauge plethysmography. Exercise tolerance was measured as the maximum walking distance achieved on a 6-minute walking test.RESULTSMaximum walking distance (HF: 178 ± 65 m; controls: 562 ± 136 m,P= .0001), and forearm vascular function after occlusion were significantly different between groups (forearm arterial inflow: HF 15.3 ± 6; controls 22 ± 6.7; forearm venous capacitance: HF 1.4 ± 0.5; controls 2.0 ± 0.4; forearm venous outflow: HF 24.5 ± 9.4; controls: 33 ± 10 mL · 100 mL tissue−1· min−1; and forearm vascular resistance: HF 7.8 ± 3; controls 4.6 ± 1.4 U). Correlation analysis revealed significant associations between all forearm vascular measurements after occlusion and maximum walking distance.CONCLUSIONThese data confirm previous studies indicating the importance of arterial reactivity on exercise tolerance in patients with HF. Additionally, the results suggest the importance of venous function as a contributing factor to exercise performance.

ISSN:0883-9212    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:0883-9212    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:0883-9212    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:0883-9212    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

PURPOSEThe objective of this study was to compare the effectiveness of a short-term pulmonary rehabilitation program with brief advice given to patients with severe ventilatory impairment due to chronic obstructive pulmonary disease (COPD).METHODSOne hundred three patients with severe COPD, defined as having forced expiratory volume in 1 second < 40% predicted, were randomly assigned to rehabilitation or to brief advice. Fifty-four patients attended a rehabilitation program twice a week for 6 weeks. Forty-nine patients attended a single session during which they were given printed educational materials and verbal advice and guidance about exercise. Subjects were reassessed at 3 months.RESULTSThe shuttle walking distance increased significantly in the rehabilitation group by 43 meters. The increase of 23 meters in the brief advice group was significantly less than in the rehabilitation group. Improvements in quality of life in the rehabilitation group were small and not clinically significant.CONCLUSIONSIn these patients with severe COPD, a short outpatient rehabilitation program of low intensity achieved small but significant improvement in shuttle walking distance, compared with brief advice. The improvements in quality of life were modest and did not reach statistical significance, although in some instances the confidence limits include differences that approach clinical significance. The relatively small effect may be due to the low intensity of the program or to the severity of the subjects’ ventilatory impairment.

ISSN:0883-9212    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:0883-9212    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:0883-9212    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:0883-9212    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:0883-9212    

出版商:OVID    

年代:2002

数据来源: OVID