(Circulation. 1995;91:1719-1724.)
© 1995 American Heart Association, Inc.
Articles |
Evaluation of Exercise Capacity Using Submaximal Exercise at a Constant Work Rate in Patients With Cardiovascular Disease
Presented in part at the annual meeting of Experimental Biology, Anaheim, Calif, April 1994.
From the Second Department of Internal Medicine (A.K., N.S., F.M., M.H.), Tokyo Medical and Dental University, Tokyo, Japan; Hokushin General Hospital (T.Y., H.K., K.S.), Nagano-ken, Japan; and Musashino Red Cross Hospital (H.A., A.N.), Tokyo, Japan.
Correspondence to Akira Koike, MD, Second Department of Internal Medicine, Tokyo Medical and Dental University, 5-45 Yushima 1-chome, Bunkyo-ku, Tokyo 113, Japan.
Background Symptom-limited incremental exercise tests are
used to estimate the severity of cardiovascular disease and the
patient's daily activity. However, there is a need for objective
parameters for submaximal exercise. To test the hypothesis that a
decrease in maximal exercise capacity can be estimated by oxygen uptake
(
O2) kinetics, we measured
the time
constant of O2 both during
the onset of
constant work rate exercise at 50 W and during recovery from this
exercise and compared it with data obtained during maximal exercise in
patients with cardiovascular disease and in normal subjects.
Methods and Results A total of 34 patients with cardiovascular
disease and 14 normal subjects performed 6 minutes of 50-W constant
work rate exercise and an incremental exercise test to the
symptom-limited maximum on a cycle ergometer.
O2 was calculated from
respiratory gas
analysis on a breath-by-breath basis. The time constant of
O2 during the onset of 50-W
exercise was
61.4±15.2 seconds in patients with cardiovascular disease,
significantly longer (the kinetics of
O2
were slower) than that in normal subjects (48.8±10.4 seconds,
P=.008). The time constant of
O2 during the onset of
exercise was
significantly negatively correlated with peak
O2
(r=-.67) and maximal work
rate (r=-.66). The time constant during recovery, which
did
not differ significantly from that of exercise, was also prolonged in
patients with cardiovascular disease; it showed a negative correlation
with peak O2
(r=-.63) and
maximum work rate (r=-.54).
Conclusions The time constant of
O2 during and after
recovery from 50 W
of constant work rate exercise, which does not require the subject's
maximal effort, is a useful and objective measure of exercise capacity
in patients with mild to moderate cardiovascular disease.
Key Words: exercise • oxygen • cardiovascular diseases
This article has been cited by other articles:
 |
|
 |
|
  T. A. Bauer, E. P. Brass, M. Nehler, T. J. Barstow, and W. R. Hiatt Pulmonary VO2 dynamics during treadmill and arm exercise in peripheral arterial disease J Appl Physiol, August 1, 2004; 97(2): 627 - 634. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Koike, H. Itoh, R. Oohara, M. Hoshimoto, A. Tajima, T. Aizawa, and L. T. Fu Cerebral Oxygenation During Exercise in Cardiac Patients Chest, January 1, 2004; 125(1): 182 - 190. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Taniguchi, K. Ueshima, I. Chiba, I. Segawa, N. Kobayashi, M. Saito, and K. Hiramori A New Method Using Pulmonary Gas-Exchange Kinetics To Evaluate Efficacy of {beta}-Blocking Agents in Patients With Dilated Cardiomyopathy Chest, September 1, 2003; 124(3): 954 - 961. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. B. Alexander, D. R. Dengel, R. J. Olson, and K. M. Krajewski Oxygen-Uptake (VO2) Kinetics and Functional Mobility Performance in Impaired Older Adults J. Gerontol. A Biol. Sci. Med. Sci., August 1, 2003; 58(8): M734 - 739. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Rickli, W. Kiowski, M. Brehm, D. Weilenmann, C. Schalcher, A. Bernheim, E. Oechslin, and H. P. Brunner-La Rocca Combining low-intensity and maximal exercise test results improves prognostic prediction in chronic heart failure J. Am. Coll. Cardiol., July 2, 2003; 42(1): 116 - 122. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. Bittner Exercise testing in heart failure: Maximal, submaximal, or both? J. Am. Coll. Cardiol., July 2, 2003; 42(1): 123 - 125. [Full Text] [PDF]
|
|
|
|
|
|
A. Koike, N. Shimizu, A. Tajima, T. Aizawa, L. T. Fu, H. Watanabe, and H. Itoh Relation Between Oscillatory Ventilation at Rest Before Cardiopulmonary Exercise Testing and Prognosis in Patients With Left Ventricular Dysfunction Chest, February 1, 2003; 123(2): 372 - 379. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E.R. Diederich, B.J. Behnke, P. McDonough, C.A. Kindig, T.J. Barstow, D.C. Poole, and T.I. Musch Dynamics of microvascular oxygen partial pressure in contracting skeletal muscle of rats with chronic heart failure Cardiovasc Res, December 1, 2002; 56(3): 479 - 486. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Koike, H. Itoh, M. Kato, H. Sawada, T. Aizawa, L. T. Fu, and H. Watanabe Prognostic Power of Ventilatory Responses During Submaximal Exercise in Patients With Chronic Heart Disease* Chest, May 1, 2002; 121(5): 1581 - 1588. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Nanas, J. Nanas, C. Kassiotis, C. Nikolaou, E. Tsagalou, D. Sakellariou, I. Terovitis, O. Papazachou, S. Drakos, A. Papamichalopoulos, et al. Early recovery of oxygen kinetics after submaximal exercise test predicts functional capacity in patients with chronic heart failure Eur J Heart Fail, December 1, 2001; 3(6): 685 - 692. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Koike, K. Kobayashi, H. Adachi, N. Shimizu, H. Itoh, M. Hiroe, and K. Wasserman Effects of Dobutamine on Critical Capillary PO2 and Lactic Acidosis Threshold in Patients With Cardiovascular Disease Chest, October 1, 2001; 120(4): 1218 - 1225. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Adachi, A. Koike, A. Niwa, A. Sato, T. Takamoto, F. Marumo, and M. Hiroe Percutaneous Transluminal Coronary Angioplasty Improves Oxygen Uptake Kinetics During the Onset of Exercise in Patients With Coronary Artery Disease Chest, August 1, 2000; 118(2): 329 - 335. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Tanabe, M. Takahashi, Y. Hosaka, M. Ito, E. Ito, and K. Suzuki Prolonged recovery of cardiac output after maximal exercise in patients with chronic heart failure J. Am. Coll. Cardiol., April 1, 2000; 35(5): 1228 - 1236. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Nanas, J. Nanas, C. Kassiotis, G. Alexopoulos, A. Samakovli, J. Kanakakis, E. Tsolakis, and C. Roussos Respiratory Muscles Performance Is Related to Oxygen Kinetics During Maximal Exercise and Early Recovery in Patients With Congestive Heart Failure Circulation, August 3, 1999; 100(5): 503 - 508. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. A. Bauer, J. G. Regensteiner, E. P. Brass, and W. R. Hiatt Oxygen uptake kinetics during exercise are slowed in patients with peripheral arterial disease J Appl Physiol, August 1, 1999; 87(2): 809 - 816. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Masaoka and I. Homma Expiratory time determined by individual anxiety levels in humans J Appl Physiol, April 1, 1999; 86(4): 1329 - 1336. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H P B.-L. Rocca, D Weilenmann, F Follath, M Schlumpf, H Rickli, C Schalcher, F E Maly, R Candinas, and W Kiowski Oxygen uptake kinetics during low level exercise in patients with heart failure: relation to neurohormones, peak oxygen consumption, and clinical findings Heart, February 1, 1999; 81(2): 121 - 127. [Abstract] [Full Text]
|
|