RESUMO
Left-ventricular dysfunction is diagnosed when the heart rate performance curve (HRPC) of patients deflects upwards during incremental exercise. The aim of this study was to investigate the effect of exercise training on the upward deflection of the HRPC in patients with cardiovascular disease.This study comprised 11 patients who had cardiovascular disease and showed an upward deflection of the HRPC. The patients underwent exercise training (aerobic training, AT intensity: 30-40 minutes, 2-3 sessions/week, and 3-month follow-up). The HRPC of the patients was measured before and after exercise training. We used a method described by Pokan for evaluating the HRPC; the performance curve (PC) index ([PC1 - PC2] × [1 + PC1 × PC2]<sup>-1</sup>) was calculated from PC1 and PC2. PC1 and PC2 refer to the heart rate response before and after the O<sub>2</sub> pulse deflection point, respectively. The PC index indicates the following: PC > 0.1, downward deflection; -0.1 ≤ PC ≤ 0.1, linear time course; PC < -0.1, upward deflection.The PC index significantly increased after exercise training (from -0.22 ± 0.09 to -0.14 ± 0.07; p < 0.05). In addition, the HRPC of 4 patients (37%) changed in linear time course.These results suggest that an upward deflection of the HRPC in patients with cardiovascular disease may shift to a linear time course after exercise training.
RESUMO
<b>Purpose:</b> The purpose of this study was to investigate the effect of non-instrumental resistance training on exercise capacity of patients with chronic heart disease. <b>Methods:</b> Nineteen elderly male patients (66.2±5.7 years) participated in the study. All had experienced coronary artery bypass surgery, coronary artery intervention, or aortic valve replacement [left ventricular ejection fraction (EF): 54.0±15.8 %]. Patients were divided into two groups. T group (N=9) performed combined aerobic and non-instrumental resistance training; and C group (N=10) performed only aerobic exercise. Resistance training involved 10 to 15 repetitions (maximum)(RM) of squats, push ups, calf raises and trunk curls. Each exercise included 3 sets of 10 repetitions repeated 3 times a week. Aerobic exercise was prescribed at the intensity of the aerobic threshold (AT) level 3 times a week. There was no significant base line for either T group or C group. <b>Results:</b> After three months of exercise, peak torque, peak VO<sub>2</sub>, and peak watts were significantly greater in T group, compared to those of C group. However, there was no significant correlation (r = .49) between the improvement of peak VO<sub>2</sub> and peak torque. <b>Conclusion:</b> It was concluded that combined aerobic and non-instrumental resistance training is more effective than aerobic exercise alone for exercise capacity of patients with chronic heart disease. Home-based non-instrumental resistance training is usually highly significant from the perspective of the exercise capacity of patients with chronic heart disease.
RESUMO
The time constants of beat-by-beat heart rate decay for the first 30 seconds (T30) after exercise is a specific index for the vagally mediated component of heart rate recovery. The aim of our study was to determine whether cardiac rehabilitation (CR) can accelerate T30 in patients after coronary artery bypass grafting (CABG) . Thirteen male patients who underwent CABG (aged 60.5±7.7years) were assigned to 7-21 day Phase I CR. Exercise training consisted of 30 minutes of aerobic exercise (bicycle ergometer) at the anaerobic threshold 2 times per day. T30 was measured as the heart rate decay regulated in patients who rested immediately after 5 minutes of pedaling exercise. After CR, T30 significantly improved from 413.3±129.7 to 300.1±124.5 sec (p<0.01) . Peak oxygen uptake (peak V02: 14.0±4.0 16.7±3.2mlin/kg: p<0.01) and heart rate at anaerobic threshold (HR @ AT: 111.9±13.4 103.6±11.7 beatsin: p<0.01) also improved significantly. There was no correlation between ΔT30 (Δ: difference before and after CR) and Δpeak VO<SUB>2</SUB>or ΔHR @ AT. These results suggest that CR for patients following CABG accelerates vagally mediated heart rate recovery after dynamic exercise.
RESUMO
Six (1.2%) of 501 patients sustained phrenic nerve injury during operation for congenital heart disease at our institutions between 1992 and 1998. The diagnosis was confirmed by percutaneous stimulation of the phrenic nerve. All but 1 patient were less than 9 months old, and the average weight was 3.6kg. All 6 patients underwent diaphragmatic plication and were extubated by 7 days after operation. Percutaneous stimulation of the phrenic nerve allowed direct assessment of phrenic nerve function which was difficult to detect by clinical and radiological evidence. This method can be non-invasively used at the bedside to facilitate early and accurate diagnosis of phrenic nerve palsy.
RESUMO
The gastrocnemius muscles are composed predominantly of type II B and II A fibers while the soleus muscle is composed of type I fibers. However, the relationships between the calcaneal bone stiffness and the triceps surae muscles consisting of the different types of skeletal muscle fibers are unknown. The purpose of this study was to investigate the relationships between the calcaneal bone stiffness and the gastrocnemius or soleus muscle thickness in 73 postmenopausal women. We measured the speed of sound (SOS) and the broad band ultrasound attenuation (BUA), using a ultrasonic measurement of the calcaneal and the gastrocnemius or soleus muscle thickness used to measure the B-mode ultrasound anatomy. There was a significant differences in age between the high-and low-SOS groups. In the high-BUA group, the body mass index, the lower leg girth and the triceps surae muscle thickness were significantly higher than those in the low-BUA group. This data indicated that SOS is related to ageing and BUA is related to the body mass or the muscle thickness. The other side, stiffness and SOS were significantly correlated with the gastrocnemius muscle thickness, but not with the soleus muscle mass. Therefore, this study suggests that the calcaneal bone stiffness is closely related to the muscle thickness, which may be related especialy to the fast twitch muscle.
