摘要:

Maximal aerobic power (&OV0312;O2max), body composition, and cardiac dimensions, including left ventricular volume and mass, were evaluated in 39 male marathon runners and 26 sedentary men similar in age and height. The runners were significantly lower in body weight (Wt) and % body fat, but similar in lean body weight (LBW) to that of the sedentary men. Both groups were similar in maximal exercise heart rate, whereas the runners were significantly lower in resting heart rates (RHR) and higher in &OV0312;O2max. Absolute dimensions for septal (IST) and posterior (LVPWT) walls were significantly (P < .05) larger in the runners. There was no significant difference between the two groups, however, in the left ventricular mass (LVM) and muscle volume (LVMV) and left ventricular volume (TLVV). There were also no significant differences between the runners and sedentary men with regard to left ventricular end-diastolic and end-systolic dimensions and volumes, stroke volume, and ejection fraction. When the cardiac dimensions, volumes, and mass were expressed relative to body surface area (BSA) and WT, the values for the runners were significantly larger than those of the sedentary men. When the measures were expressed relative to LBW, however, only IST was significantly larger in the runners. The increase in the number of significant differences between the groups when the dimensions were expressed relative to BSA and WT indicates that standardization by these units leads to erroneous conclusions as to the presence and magnitude of cardiac hypertrophy. Although the runners had slightly thicker septum and posterior walls, left ventricular mass was similar between the runners and controls. Our findings suggest that the concept that endurancetraining produces cardiac hypertrophy should be interpreted with caution.

ISSN:0275-1429    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

The purpose of this study was to establish the feasibility, safety, and cardiovascular responses to predischarge symptom-limited graded exercise testing (GXT) after cardiac valvular surgery. Twenty patients, 15 men and five women aged 19 to 74 (mean 38.1 ± 13.4 years), were administered a treadmill symptom-limited GXT (modified Naughton protocol) 14 + 7 days after surgery. Seven patients underwent aortic valve replacement (AVR), five underwent mitral valve replacement (MVR), four underwent combined AVR and MVR, one had pulmonary valve repair, one had MVR and pulmonary valve replacement (PVR) and tricuspid valve annuloplasty, and two underwent open mitral valvotomy. Seventeen of 20 patients presented with acute endocarditis, congestive heart failure Class HI or IV, or symptoms or signs of severe aortic or pulmonary stenosis that precluded presurgical exercise tolerance evaluation. Valve surgery was followed by a marked early improvement in effort tolerance at high peak heart rate and double product, which could be shown clearly by early symptom-limited GXT. The heart rate increased from 92 ± 14 to 148 ± 15 beats/min; systolic blood pressure, from 106 ± 16 to 149 ± 21 mm Hg; rate-pressure product, from 97 ± 17 to 221 ± 42 ± 102from rest to maximum, respectively. The maximum estimated functional capacity was 6.7 ± 1.3 METs. No complications occurred. The exercise test was terminated because of fatigue in 17 patients, left ankle pain in one patient, chest scar pain in one patient, and a four-beat run of ventricular tachycardia in one patient. In conclusion, symptom-limited GXT is a safe and feasible procedure before discharge after cardiac valvular surgery. This procedure is useful in early evaluation of the functional status after valvular surgery and in facilitating an exercise prescription for these patients for outpatient rehabilitation.

ISSN:0275-1429    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Several nonmedical as well as medical factors are known to influence a patient's return- to-work decision after a major cardiac event. Because of the negative ramifications associated with loss of employment, it is important to determine as accurately as possible which patients can medically resume work with a reasonable level of stress. Several noninvasive assessment procedures can be used in establishing a prescription for work resumption. Some of these include a clinical assessment, jobanalysis, graded dynamic exercise testing, simulated work testing, and ambulatory monitoring. A prescription for exercise conditioning may also result in physiologic and psychologic benefits that enhance the patient's ability to resume work. For patients who need to find new employment, retraining opportunities should be explored. Through appropriate assessment and rehabilitation processes, it may be possible to minimize inappropriate disability after a cardiac event.

ISSN:0275-1429    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

A comprehensive post-myocardial infarction (MI) rehabilitation program that is adapted to district hospital resources is presented. The program includes follow-up at a post-MI clinic, physical training in outpatient groups, and the provision of information and psychological support to patients and their families. In a retrospective study, an intervention group of 143 consecutive nonselected MI patients participating in the program was compared with a reference group of 154 MI patients receiving standard care. One year after MI, there was no difference in mortality between the two groups, but the intervention group had a significantly lower rate of nonfatal reinfarctions (5.4% versus 16.2%, P < .01), fewer uncontrolled hypertensives, and fewer smokers. Fewer patients were receiving long-acting nitroglycerin and sedative drugs. The program was found to be highly effective, and the dropout rate was low. It was concluded that this comprehensive rehabilitation program offers an effective and inexpensive method of secondary prevention after myocardial infarction.

ISSN:0275-1429    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

The case history of a survivor of myocardial infarction at very high risk for secondary cardiac events is presented because despite interaction of major psychologic problems, refusal of recommended coronary artery bypass graft surgery, and obesity, there was remarkable weight loss, functional improvement, and survival for five years. This outcome resulted from psychotherapy and unsupervised exercise conditioning. Nevertheless, serial exercise testing and recurrence of clinical symptoms indicate progression of coronary artery disease.

ISSN:0275-1429    

出版商:OVID    

年代:1985

数据来源: OVID

ISSN:0275-1429    

出版商:OVID    

年代:1985

数据来源: OVID

ISSN:0275-1429    

出版商:OVID    

年代:1985

数据来源: OVID

ISSN:0275-1429    

出版商:OVID    

年代:1985

数据来源: OVID

ISSN:0275-1429    

出版商:OVID    

年代:1985

数据来源: OVID