Ergometry – ABC CARDIOL

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Original Article

Sex-Specific Equations to Estimate Maximum Oxygen Uptake in Cycle Ergometry

Christina G. de Souza e Silva et al. Claudio Gil S. Araújo

Abstract

Background:

Aerobic fitness, assessed by measuring VO₂max in maximum cardiopulmonary exercise testing (CPX) or by estimating VO₂max through the use of equations in exercise testing, is a predictor of mortality. However, the error resulting from this estimate in a given individual can be high, affecting clinical decisions.

Objective:

To determine the error of estimate of VO₂max in cycle ergometry in a population attending clinical exercise testing laboratories, and to propose sex-specific equations to minimize that error.

Methods:

This study assessed 1715 adults (18 to 91 years, 68% men) undertaking maximum CPX in a lower limbs cycle ergometer (LLCE) with ramp protocol. The percentage error (E%) between measured VO₂max and that estimated from the modified ACSM equation (Lang et al. MSSE, 1992) was calculated. Then, estimation equations were developed: 1) for all the population tested (C-GENERAL); and 2) separately by sex (C-MEN and C-WOMEN).

Results:

Measured VO₂max was higher in men than in WOMEN: -29.4 ± 10.5 and 24.2 ± 9.2 mL.(kg.min)^-1 (p < 0.01). The equations for estimating VO₂max [in mL.(kg.min)^-1] were: C-GENERAL = [final workload (W)/body weight (kg)] x 10.483 + 7; C-MEN = [final workload (W)/body weight (kg)] x 10.791 + 7; and C-WOMEN = [final workload (W)/body weight (kg)] x 9.820 + 7. The E% for MEN was: -3.4 ± 13.4% (modified ACSM); 1.2 ± 13.2% (C-GENERAL); and -0.9 ± 13.4% (C-MEN) (p < 0.01). For WOMEN: -14.7 ± 17.4% (modified ACSM); -6.3 ± 16.5% (C-GENERAL); and -1.7 ± 16.2% (C-WOMEN) (p < 0.01).

Conclusion:

The error of estimate of VO₂max by use of sex-specific equations was reduced, but not eliminated, in exercise tests on LLCE.

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Artigo Original

Time of Exercise as Indicator of Quality Control in Ergometry Services

Romeu Sergio Meneghelo et al. Samira Saady Morhy Paola Zucchi

Background:

The search for quality requires assessment tools in the various subdivisions of a health complex. In diagnostic medicine, they are scarce and in ergometry suggestions of indicators were not found.

Objective:

To establish indicator for quality control on ergometry based on III Guidelines of the Brazilian Cardiology Society About Ergometric Test; to verify the percentage of tests that have presented the indicator within the compliance in two services of the same institution before and after the publication of the document.

Methods:

A critical analysis of the guidelines in the search for indicator that would present: accuracy, reliability, simplicity, validity, sensitivity and ability to quantitatively measure the variations in the behavior of quality criteria and that would be applicable to all tests. The indicator was applied in tests of 2010 and 2011 prior to the publication, and after it was adopted by two services of the same institution.

Results:

The indicator that has met the criteria was the percentage of ergometric tests with exercise duration between 8 and 12 minutes. In the years 2010 and 2011, respectively, the percentage of ergometric tests within compliance were 85.5% and 86.1% (p = 0.068) at the General Hospital, and 81.5% and 85.7% (p <0.001) the Service of Periodic Health Assessment.

Conclusion:

The exercise time between 8 and 12 minutes can be used as a quality criterion in ergometric and services where it was applied, at least 80% of the ergometric tests were compliant.

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Artigo Original

Maximal heart rate: influence of sport practice during childhood and adolescence

Débora Helena Balassiano et al. Claudio Gil Soares de Araújo

BACKGROUND: The heart rate (HR) achieved at the end of an exercise test (ET) is called maximal HR and is known to have clinical and epidemiological relevance. For its correct measurement, it is necessary that the ET be truly maximal. OBJECTIVE: To evaluate the influence of a history of intense physical activity and/or participation in sports competitions during youth on the maximal HR (% of age-predicted HR) on a clinical cardiopulmonary exercise test (CPET). METHODS: A total of 600 non-athlete individuals (65.8% males) with a mean age of 46 ± 13.7 years, under primary prevention of cardiovascular diseases and who underwent maximal CPET, were retrospectively selected. Their physical activity profile during childhood/adolescence (PAPCA) was classified in scores growing from 0 to 4, with value 2 corresponding to their respective age-predicted levels. RESULTS: None of the 20 individuals with maximal HR values equal to or greater than 200 bpm had been inactive or somewhat active during childhood/adolescence. A significant association was observed between PAPCA scores and maximal HR (% of age-predicted HR) (p = 0.02), with a 7-bpm higher value for PAPCA scores 3-4 (32.9% of the sample) in comparison to PAPCA 0-2. CONCLUSION: Two hypotheses exist to explain these results in individuals who had been more active during youth: a) persistence of chronic adaptations to training on the cardiac chronotropism, or b) higher ability and/or motivation to achieve a truly maximal CPET. Information on the physical activity profile during childhood / adolescence may contribute to the interpretation of maximal HR on ET.

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Artigo Original

Electrocardiographic score: application in exercise test for the assessment of ischemic preconditioning

Augusto Uchida et al. Paulo Moffa Whady Hueb Luiz Antonio Machado Cesar … Beatriz Moreira Ayub Ferreira Jose Antonio Franchini Ramires

BACKGROUND: The time for 1.0 mm ST-segment depression (T-1.0mm) adopted to characterize ischemic preconditioning (IPC) in sequential exercise tests is consistent and reproducible; however, it has several limitations. OBJECTIVE: To apply an electrocardiographic score of myocardial ischemia in sequential exercise tests, comparing it to the conventional T-1.0 mm index. METHODS: Sixty one patients with mean age of 62.2 ± 7.5 years were evaluated; 86.9% were males. A total of 151 tests were analyzed, 116 of which were from patients who completed two assessment phases. The first phase comprised two sequential exercise tests for the documentation of IPC; the second phase, initiated one week later, comprised two more tests carried out under the effect of repaglinide. Two observers who were blind to the tests applied the score. RESULTS: Perfect inter and intraobserver agreement was found (Kendall tau-b = 0.96, p < 0.0001, and Kendall tau-b = 0.98, p < 0.0001, respectively). Values of sensitivity and specificity, negative predictive value, positive predictive value and accuracy were 72.41%, 89.29%, 75.8%, 87.5% and 81.0%, respectively. CONCLUSION: The ischemic score is a consistent and reproducible method for the documentation of IPC, and is a feasible alternative to T-1.0 mm.

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Sex-Specific Equations to Estimate Maximum Oxygen Uptake in Cycle Ergometry

Abstract

Background:

Objective:

Methods:

Results:

Conclusion:

Time of Exercise as Indicator of Quality Control in Ergometry Services

Background:

Objective:

Methods:

Results:

Conclusion:

Maximal heart rate: influence of sport practice during childhood and adolescence

Electrocardiographic score: application in exercise test for the assessment of ischemic preconditioning

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Electronic Document Format (Vancouver)

Electronic Document Format (ABNT)

Electronic Document Format (APA)

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Electronic Document Format (Vancouver)

Electronic Document Format (ABNT)

Electronic Document Format (APA)

Electronic Document Format (ISO)