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  • 1
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    Online Resource
    Overshoot of the Respiratory Exchange Ratio during Recovery from Maximal Exercise Testing in Kidney Transplant Recipients
    MDPI AG ; 2021
    In:  International Journal of Environmental Research and Public Health Vol. 18, No. 17 ( 2021-09-01), p. 9236-
    Details
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 18, No. 17 ( 2021-09-01), p. 9236-
    Abstract: The overshoot of the respiratory exchange ratio (RER) during recovery from exercise has been found to be reduced in magnitude among patients with heart failure. The aim of this study is to investigate whether this phenomenon could also be present in patients with peripheral, and not cardiac, limitations to exercise such as kidney transplant recipients (KTRs). In this retrospective cross-sectional study, KTRs were evaluated with maximal cardiopulmonary exercise testing (CPET) assessing the RER overshoot parameters during recovery: the RER at peak exercise, the maximum RER value reached during recovery, the magnitude of the RER overshoot (RER mag = (RER max-peak RER)/peak RER%) and the linear slope of the RER increase after the end of exercise. A total of 57 KTRs were included in the study (16 females), all of them showing a significant RER overshoot (RER mag: 28.4 ± 12.7%). Moreover, the RER mag showed significant correlations with the fitness of patients (peak VO2: ρ = 0.57, p 〈 0.01) and cardiorespiratory efficiency (VE/VCO2 slope: r = −0.32, p 〈 0.05; oxygen uptake efficiency slope (OUES): r = 0.48, p 〈 0.01). Indeed, the RER mag was significantly different between the subgroups stratified by Weber’s fitness class or a ventilatory efficiency class. Our study is the first to investigate recovery of the RER in a population of KTRs, which correlates well with known prognostic CPET markers of cardiorespiratory fitness, determining the RER mag as the most meaningful RER overshoot parameter. Thus, the RER recovery might be included in CPET evaluations to further improve prognostic risk stratifications in KTRs and other chronic diseases.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    URL: Article
    DOI: 10.3390/ijerph18179236
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2175195-X
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  • 2
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    Physical Fitness as a Prognostic Marker for Infectious Events in Kidney Transplant Recipients
    S. Karger AG ; 2022
    In:  American Journal of Nephrology Vol. 53, No. 1 ( 2022), p. 1-9
    Details
    In: American Journal of Nephrology, S. Karger AG, Vol. 53, No. 1 ( 2022), p. 1-9
    Abstract: 〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 Infectious events are one of the leading causes of death in kidney transplant recipients (KTRs). KTRs have reduced cardiorespiratory fitness (CRF), a predictor for infections in other populations. The aim of this study was to investigate whether CRF and muscle strength are prognostic markers for infectious events in KTRs. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 In this retrospective cohort study, 155 KTRs underwent an incremental, maximal cardiopulmonary exercise test (CPET) 3 months after transplantation. CRF was analyzed with peak oxygen consumption (VO 〈 sub 〉 2 〈 /sub 〉 peak) while muscle strength with isometric handgrip (HG) test. Laboratory blood samples and drug therapy were collected. The median follow-up period was 54 (interquartile range 38–62) months. Cox regression analyses were performed to evaluate predictors of infectious events adjusting for potential confounders. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 During this study, severe infectious events occurred in 41 subjects (26.5%). 15.5% ( 〈 i 〉 n 〈 /i 〉 = 24) of patients had a severely reduced CRF, defined as a VO 〈 sub 〉 2 〈 /sub 〉 peak below the 5th percentile of the reference values reported for a matched healthy population. The hazard ratio for infectious events in this subgroup was 2.389 (95% CI = 1.188–4.801, 〈 i 〉 p 〈 /i 〉 = 0.014), independently of gender, age, BMI, time on dialysis, hemoglobin concentration, eGFR, diabetes, and immunosuppressive regimen. On the contrary, no significant association of HG strength and infections was found. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 Therefore, low CRF may be considered as a modifiable predictor of severe infectious events in KTRs. A CPET should thus be recommended for cardiovascular screening, evaluation of CRF, and tailored exercise prescription to reduce the risk of infections and potentially improve long-term outcomes of transplantation.
    Type of Medium: Online Resource
    ISSN: 0250-8095 , 1421-9670
    URL: Article
    DOI: 10.1159/000520758
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2022
    detail.hit.zdb_id: 1468523-1
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  • 3
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    Early repolarization in adolescent athletes: A gender comparison of ECG and echocardiographic characteristics
    Wiley ; 2022
    In:  Scandinavian Journal of Medicine & Science in Sports Vol. 32, No. 11 ( 2022-11), p. 1581-1591
    Details
    In: Scandinavian Journal of Medicine & Science in Sports, Wiley, Vol. 32, No. 11 ( 2022-11), p. 1581-1591
    Abstract: The early repolarization pattern (ERp) is an electrocardiographic finding previously associated with arrhythmic risk in adults. The purpose of this study is to evaluate the prevalence and characteristics of ERp in a group of adolescent athletes according to gender. Furthermore, potential associations with clinical, electrocardiographic, and echocardiographic parameters are explored. Methods In this cross‐sectional study young athletes (age  〈  18 years) were consecutively enrolled during the annual pre‐participation evaluation, undergoing also transthoracic echocardiography assessment from January 2015 to March 2020. Results The prevalence of ERp was 27% in the whole population. Athletes with ERp were more frequently men practicing endurance sports. Women with ERp showed lower heart rate at rest, greater posterior, and relative ventricular wall thickness than those without ERp. Men with ERp presented higher systolic blood pressure at peak exercise, greater septal wall thickness, and indexed left ventricular mass than those without ERp. Both genders with ERp showed increased QRS voltage and narrower QRS duration. The ERp phenotype in men was more frequently notched with higher amplitude and ascending ST segment. Women's ERp presented more frequently a slurred morphology, especially in the inferior leads, and horizontal ST slope. No differences emerged in the occurrence of arrhythmias at rest and during maximal exercise test between groups, even considering higher risk phenotypes. Conclusions ERp is an ECG finding compatible with normal cardiac adaptations to training in young athletes. ERp demonstrated gender differences regarding phenotypes previously associated with increased cardiovascular risk, not showing any differences in arrhythmias during maximal exercise test.
    Type of Medium: Online Resource
    ISSN: 0905-7188 , 1600-0838
    URL: Issue
    URL: Article
    DOI: 10.1111/sms.v32.11
    DOI: 10.1111/sms.14232
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2025503-2
    SSG: 31
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  • 4
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    Exercise Capacity and Cardiorespiratory Fitness in Children with Congenital Heart Diseases: A Proposal for an Adapted NYHA Classification
    MDPI AG ; 2022
    In:  International Journal of Environmental Research and Public Health Vol. 19, No. 10 ( 2022-05-12), p. 5907-
    Details
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 19, No. 10 ( 2022-05-12), p. 5907-
    Abstract: Objective: To propose and evaluate an adapted NYHA classification for children with congenital heart disease (CHD) as a feasible clinical tool for classifying patients’ fitness, cardiorespiratory efficiency and functional limitations during their ordinary daily activities, which are also characterized by vigorous and competitive physical exercise among peers. Methods: This cross-sectional investigation analyzed 332 patients (13.1 ± 3.01 y/o) who underwent surgical repair of CHD and performed Cardiopulmonary Exercise Testing (CPET). Patients were divided into NYHA class I, IIA and IIB by specific questioning regarding functional limitation and performance compared to peers and at strenuous intensity. Class IIA was characterized by slight exercise limitation only for strenuous/competitive activities, whereas IIB for already ordinary physical activities. These NYHA classes were compared with maximal CPET on treadmill. Results: Patients’ exercise capacity (exercise time, METs), aerobic capacity (VO2peak) and chronotropic response were found progressively impaired when NYHA class I was compared with IIA and IIB. Indeed, ventilatory-perfusion mismatch (PETCO2, VE/VCO2) significantly worsened from NYHA class I to IIA, while no difference was found between IIA and IIB. Conclusion: This adapted NYHA-CHD classification could allow regular functional evaluations and accurate assessments by clinicians, leading to facilitated clinical management and timely medical interventions.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    URL: Article
    DOI: 10.3390/ijerph19105907
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
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  • 5
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    Selective Functional Movement Assessment (SFMA) Reliability and Proposal of Its Use in Sports
    MDPI AG ; 2023
    In:  International Journal of Environmental Research and Public Health Vol. 20, No. 3 ( 2023-01-22), p. 2032-
    Details
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 20, No. 3 ( 2023-01-22), p. 2032-
    Abstract: Introduction: The Selective Functional Movement Assessment (SFMA) is a functional movement assessment method to observe movement restrictions in individuals with known musculoskeletal disorders, although it has also been used to evaluate healthy athletes of different sports. Aim: The present paper aimed to evaluate the applicability of SFMA in a clinical setting and to verify whether a student can correctly perform it. Methods: An introductory and explanatory email was sent to the subjects, containing the instructions needed to produce a video with SFMA evaluation movements. SFMA methodology was then used to analyze the received videos. The results between interobserver and intraobserver agreement were compared to the literature, considered the gold standard methods. Results: Twenty-eight subjects (17.71 ± 1.96 years aged) were rated. The functional non-painful scenario (FN) has been assigned more frequently by all raters. The student’s intra-rater reliability proved to be moderate (Kappa coefficient 0.49). Results for inter-rater reliability showed that the reliability degree between the senior physiotherapist and student before and after their educational path is good (Kappa coefficient 0.60 and 0.62, respectively). Conclusions: The results of this study showed SFMA intra-rater reliability to be moderate, while inter-rater reliability can be considered good. These characteristics make it a valuable tool for sport’s needs, even when used by students.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    URL: Article
    DOI: 10.3390/ijerph20032032
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
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  • 6
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    Are Gyms a Feasible Setting for Exercise Training Interventions in Patients with Cardiovascular Risk Factors? An Italian 10-Years Cross-Sectional Survey Comparison
    MDPI AG ; 2022
    In:  International Journal of Environmental Research and Public Health Vol. 19, No. 4 ( 2022-02-19), p. 2407-
    Details
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 19, No. 4 ( 2022-02-19), p. 2407-
    Abstract: Background: Exercise training is a known important prevention and treatment modality in patients with cardiovascular (CV) diseases. However, the CV risk factors in gym users have been poorly studied. The aim of this study was to monitor CV risk factors of gym users over 10 years in order to investigate whether gyms are used settings for secondary disease prevention. Methods: In 2007 and 2017, a cross-sectional research survey was adopted to determine CV risk factors and habits in gym users (18–69 years) of the Veneto region. These data were analyzed and compared with those of PASSI, a national surveillance system of the Italian population. Results: During the last decade, there has been an increase in gym users over 50 years of age and in people with arterial hypertension and hypercholesterolemia. People attending the gym on medical referral are increasing, but they are still few ( 〈 10%). When comparing the collected data with PASSI surveillance, most of the CV risk factors are strongly underrepresented in gym users. Conclusion: The prevalence of gym users with CV risk factors is rather low, regardless of age. Physicians still need to encourage and prescribe physical exercise for secondary prevention and treatment of chronic diseases.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    URL: Article
    DOI: 10.3390/ijerph19042407
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
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  • 7
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    Potential Cost Savings for the Healthcare System by Physical Activity in Different Chronic Diseases: A Pilot Study in the Veneto Region of Italy
    MDPI AG ; 2022
    In:  International Journal of Environmental Research and Public Health Vol. 19, No. 12 ( 2022-06-16), p. 7375-
    Details
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 19, No. 12 ( 2022-06-16), p. 7375-
    Abstract: Background: Sedentary behaviour (SB) and physical inactivity (PI) are associated with an increased risk of chronic diseases and a significant economic burden. This pilot study aims to estimate the possible cost savings for the Veneto Regional Health Service (Italy) due to a population-based physical activity (PA) intervention. Methods: The PA-related cost-savings were assessed for four chronic diseases in the whole and sedentary populations of the Veneto region. The SB and PA epidemiological data, regarding an additional percutaneous coronary intervention in coronary artery disease, hospitalizations in chronic obstructive pulmonary disease, surgery for colorectal cancer, and femur fracture, were obtained from national and regional administrative sources. A relative risk reduction, due to PA, was obtained from the recent literature. The annual healthcare costs were estimated using the regional diagnosis-related group tariffs. Results: The annual estimated cost-savings for the regional healthcare service related to these four outcomes: an amount between EUR 5,310,179 (if a conservative analysis was performed) and EUR 17,411,317. Conclusion: By a downward estimate, regarding the direct healthcare costs, PA interventions could lead to important cost-savings in the Veneto region. The savings would be greater when considering the cross-sectional impact on other healthcare costs, comorbidities, and indirect costs.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    URL: Article
    DOI: 10.3390/ijerph19127375
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
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  • 8
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    Overshoot of the Respiratory Exchange Ratio during Recovery from Maximal Exercise Testing in Young Patients with Congenital Heart Disease
    MDPI AG ; 2023
    In:  Children Vol. 10, No. 3 ( 2023-03-07), p. 521-
    Details
    In: Children, MDPI AG, Vol. 10, No. 3 ( 2023-03-07), p. 521-
    Abstract: Introduction: The overshoot of the respiratory exchange ratio (RER) after exercise is reduced in patients with heart failure. Aim: The present study aimed to investigate the presence of this phenomenon in young patients with congenital heart disease (CHD), who generally present reduced cardiorespiratory fitness. Methods: In this retrospective study, patients with CHD underwent a maximal cardiopulmonary exercise testing (CPET) assessing the RER recovery parameters: the RER at peak exercise, the maximum RER value reached during recovery, the magnitude of the RER overshoot and the linear slope of the RER increase after the end of the exercise. Results: In total, 117 patients were included in this study. Of these, there were 24 healthy age-matched control subjects and 93 young patients with CHD (transposition of great arteries, Fontan procedure, aortic coarctation and tetralogy of Fallot). All patients presented a RER overshoot during recovery. Patients with CHD showed reduced aerobic capacity and cardiorespiratory efficiency during exercise, as well as a lower RER overshoot when compared to controls. RER magnitude was higher in the controls and patients with aortic coarctation when compared to those with transposition of great arteries, previous Fontan procedure, and tetralogy of Fallot. The RER magnitude was found to be correlated with the most relevant cardiorespiratory fitness and efficiency indices. Conclusions: The present study proposes new recovery indices for functional evaluation in patients with CHD. Thus, the RER recovery overshoots analysis should be part of routine CPET evaluation to further improve prognostic risk stratifications in patients with CHD.
    Type of Medium: Online Resource
    ISSN: 2227-9067
    URL: Article
    DOI: 10.3390/children10030521
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2732685-8
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  • 9
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    The Effect of Exercise Training on Irisin Secretion in Patients with Type 2 Diabetes: A Systematic Review
    MDPI AG ; 2022
    In:  Journal of Clinical Medicine Vol. 12, No. 1 ( 2022-12-21), p. 62-
    Details
    In: Journal of Clinical Medicine, MDPI AG, Vol. 12, No. 1 ( 2022-12-21), p. 62-
    Abstract: Introduction: Irisin is a myokine considered to be a potential mediator of exercise-induced energy metabolism and its secretion is known to promote the browning of beige fat cells in white adipose tissue. However, it is currently not known which exercise protocol is the best to enhance irisin concentration in patients with type 2 diabetes (T2D). Objective: The purpose of this study is to provide a review investigating the irisin response to different exercise training modalities and intensities in T2D. Methods: A systematic literature search was performed in May 2022. Results: After the selection process from 938 articles, six studies were included. Selected papers presented different exercise training interventions regarding intensity and modality. One study reported no significant differences in serum irisin levels after exercise training, whereas the other five showed a higher increase in serum irisin levels after exercise training with higher differences in irisin secretion after high-intensity training (HIT). No consideration was possible on exercise modalities. Conclusions: The impact of training intensity and modality was found to be partly discordant but data seem to suggest that HIT promotes greater irisin secretion. Despite the limited evidence, HIT, both in interval and continuous modalities, could be suggested as valid exercise training to increase circulating irisin in patients with T2D.
    Type of Medium: Online Resource
    ISSN: 2077-0383
    URL: Article
    DOI: 10.3390/jcm12010062
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2662592-1
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  • 10
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    Association Between Penile Color Doppler Ultrasonography and Cardiorespiratory Fitness in Patients With Vascular Erectile Dysfunction
    Oxford University Press (OUP) ; 2021
    In:  Sexual Medicine Vol. 9, No. 3 ( 2021-06-01), p. 100347-100347
    Details
    In: Sexual Medicine, Oxford University Press (OUP), Vol. 9, No. 3 ( 2021-06-01), p. 100347-100347
    Abstract: Vascular erectile dysfunction (ED) is a burdensome condition, associated with increased cardiovascular risk. Peak systolic velocity (PSV) represents the maximum pulse velocity in the cavernous artery measured by a penile color doppler ultrasonography (PCDU) during a pharmacologically induced erection and is considered a reliable parameter for the diagnosis of vascular ED. However, the cut-off value of standard PSV (30 cm/s) provides high sensitivity only in the diagnosis of advanced arteriogenic disease. Thus, an age-adjusted PSV (6.73 + 0.7 x age cm/s) has been proposed to offer a more accurate diagnosis of vascular ED. Aim In this study it was aimed to answer the following question: “Is there any positive association between indexes of vascular erectile dysfunction and cardiorespiratory fitness?” Main Outcome Measure And Methods 25 patients with a medical history of ED (median age 55.3 years) underwent PCDU after pharmacological stimulation. Subsequently, a functional evaluation with ECG-monitored, incremental, maximal cardiopulmonary exercise testing was performed. Results Peak oxygen uptake (VO2 peak), peak oxygen uptake per body weight (VO2 peak/kg) and Watt/kg correlated with standard PSV, even when corrected for age and BMI (p & lt; 0.05). No differences emerged in cardiopulmonary fitness between pathological and healthy patients (4 vs 21) identified using the standard PSV cut-off. Conversely, the age-adjusted PSV cut-off identified a greater number of patients as pathological (18 vs 7), presenting a significantly lower cardiopulmonary fitness, exercise capacity and efficiency when compared to patients with normal age-adjusted PSV (all p & lt; 0.05). Conclusion Data showed an age and BMI independent association between vascular disfunction of cavernous artery and cardiopulmonary fitness, a known solid predictor of all-cause and disease-specific mortality. Moreover, the age-adjusted PSV better identified a subgroup of patients with vascular ED presenting impaired cardiorespiratory fitness and thus increased cardiovascular risk.
    Type of Medium: Online Resource
    ISSN: 2050-1161
    URL: Article
    DOI: 10.1016/j.esxm.2021.100347
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 2734882-9
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