• Title/Summary/Keyword: 운동부하 검사

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The Correlation between HRCT Emphysema Score and Exercise Pulmonary Testing Parameters (HRCT Emphysema Scoring과 운동부하 폐기능검사 지표들 간의 상관관계)

  • Choi, Eun-Kyoung;Choi, Young-Hee;Kim, Doh-Hyung;Kim, Yong-Ho;Yoon, Se-Young;Park, Jae-Seuk;Kim, Keun-Youl;Lee, Kye-Young
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.4
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    • pp.415-425
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    • 2001
  • Background : The correlation between the high resolution computed tomography(HRCT) emphysema score and the physiologic parameters including resting and exercise pulmonary function test was investigated in 14 patients($60.6{\pm}10.3$ years) with pulmonary emphysema. Methods : The patients underwent a HRCT, a resting pulmonary function test, and incremental exercise testing(cycle ergometer, 10 W/min). Computed tomography scans were obtained on a GE highlight at 10 mm intervals using 10 mm collimation, from the apex to the base after a full inspiration. The emphysema scores were determined by a CT program 'Density mask' outlining the areas with attenuation values less than -900 HU, indicating the emphysema areas, and providing an overall percentage of lung involvement by emphysema. Results : Among the resting PFT parameters, only the diffusing capacity(r=-0.75) and $PaO_2$ (r=-0.66) correlated with the emphysema score(p<0.05). Among the exercise test parameters, the emphysema score correlated significantly with the maximum power(r=-0.74), maximum oxygen consumption(r=-0.68), anaerobic threshold(V-slope method: r=-0.69), maximal $O_2$-pulse(r=-0.73), and the physiologic dead space ratio at the maximum workload(r=-0.80)(p<0.01). Conclusion: We could find that exercise testing parameters showed a much better correlation with the HRCT emphysema score, which is known to have a good correlation with the pathologic severity than the resting PIT parameters. Therefore it is suggested that exercise testing is superior to resting PIT for estimating in the estimation of the physiologic disturbance in emphysema patients.

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The role of the pulmonary function test and the exercise test for assessing impairment/disability in patients with chronic airflow obstruction (심한 만성기류폐쇄 환자의 Impairment/Disability 측정에 있어 폐기능검사 및 운동부하검사의 역할)

  • Cheon, Seon-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.3
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    • pp.377-387
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    • 1996
  • Background : In 1980, WHO made a definition in which the term "impairment" as applied to the respiratory system is used to describe loss of lung function, "disability" the resulting diminution in exercise capacity. The measurement of pulmonary function during exercise would give us information about overall functional capacity and respiratory performance that would be lacking in tests performed at rest. We conducted this study to investigate the role of resting pulmonary function test and exercise test for assessing impairment/disability in patients with chronic airflow obstruction(CAO). Method : We studied 19 patients with CAO. The spirometry and body plethysmograph were performed in stable condition. And then patients performed a progressive incremental exercise test to a symptom-limited maximum using cycle ergometer. Patients were divided in two groups, severe and non-severe impairment, according to the resting PFTs and compaired each other. A patient was considered to be severely impaired if FVC < 50 %, FEV1 < 40 % or FEV1/FVC < 40 %. Results : 1) The airway obstruction and hypoxemia of severe impairment group were more severe and exercise performance was markedly reduced compairing to non-severe impairment group. 2) The severe impairment group showed ventilatory limitation during exercise test and the limiting symptomes ware dyspnea in 9/10 patients. 3) The impairment and disability of the patients with tuberculous destructed lung were most marked in patients with CAO. 4) The FEV1 was the most prevalent criterion for the determination of severe impairment based on resting PFTs and was the valuable best correlated to V02max(r=0.81, p < 0.001). 5) The sensitivity of exercise limits for predicting severe disability according to resting PFTs was 80 % and specificity 89 %. Conclusion : In patients with severe CAO, FEV1 is a good predictive of exercise performance and impairment measured by resting PFTs can predict a disability by exercise test.

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Effects of Cardiac Rehabilitation in Elderly Patients After Myocardial Infarction (노인 심근경색 환자에서의 심장재활의 효과)

  • KIM, JI HEE
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.9
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    • pp.464-471
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    • 2016
  • To investigate the effects of cardiac rehabilitation (CR) on cardiopulmonary exercise capacity in both elderly and younger patients with myocardial infarction (MI). Of the MI patients who received hospital-based CR between February 2012 and December 2015, we retrospectively reviewed the medical records of patients who continued a follow-up through the outpatient clinic. A total of 46 patients (18 elderly patients (${\geq}60years$) and 28 younger patient (< 60)) were included in this study. The subjects visited the clinic to perform aerobic exercises with ECG monitoring based on their initial exercise tolerance test outcome. The exercise capacity was measured by symptom-limited exercise tests before and after hospital-based CR. Before CR, the elderly group had a significantly lower exercise capacity in peak VO2, METs, anaerobic threshold, exercise time, respiratory exchange ratio (RER) than the younger group. After CR, elderly groups showed a significantly improved exercise capacity in exercise time, HRmax, HRrest, peak VO2, METs, anaerobic threshold, and RER. Both elderly and younger groups showed similar improvement of cardiopulmonary exercise capacity after hospital-based CR. There is a very low cardiac rehabilitation participation and referral rates with MI patients in Korea. It is considered necessary to further expand the participation of cardiac rehabilitation in elderly MI patients.

Comparison of Exercise Pulmonary Function Test Using by Treadmill and Bicycle Ergometer in Patients with Respiratory Diseases (호흡기 질환 환자에서 자전거 타기와 답차를 이용한 운동 부하 폐기능 검사의 비교)

  • Park, Ji-Hyun;Lee, Heung-Bum;Lee, Yong-Chul;Rhee, Yang-Kuen
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.3
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    • pp.386-393
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    • 1999
  • Objective : Cardiopulmonary exercise testing in patients with heart and lung problems is used to assess functional capacity, evaluate responses to medical treatment, plan for exercise therapy, assess progression of disease process, and determine prognosis. Particularly in the patients with lung cancer, the exercise pulmonary function test gives significant physiologic assessment of the lung resection candidate. Common exercise modalities are running and cycling. Until now, the comparison of two tests mainly has been done in normal person and patients with cardiac diseases. This study is designed to compare the treadmill and bicycle exercise pulmonary function test in patients with respiratory diseases. Methods : Twenty one patients underwent a progressively incremental exercise test to the symptom-limited stage with the treadmill (Vmax29 Sensor Medics, USA) and the bicycle(model No. 2,900 Sensor Medics, USA) with 7 days apart between the two tests. Measurements were made of the metabolic, cardiorespiratory parameters, blood gases, and symptoms. Results : The results of the treadmill exercise showed significant elevation in the $VO_2$max, VEmax, and anaerobic threshold compared to those of bicycle exercise. In contrast, the results of the breathing and heart rate reserve showed the reverse. Conclusion : These results suggest that the type of exercise should be taken into consideration when interpreting exercise test in patients with respiratory diseases.

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The Effects of the Walking Exercise on ST/HR Slope and QRS Vector in the Middle-Aged Men (운동부하 심전도를 이용한 중년 남성들의 걷기 운동이 ST/HR 경사 및 QRS 벡터에 미치는 영향)

  • Kim, Duk-Jung
    • Journal of Life Science
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    • v.20 no.1
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    • pp.71-76
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    • 2010
  • The purpose of this study was to investigate the changes of long term ECG response in a company with middle-aged male employees. Subjects were 60 men who were 40~55 years old. We enrolled 30 exercise group subjects into a 3-year exercise program. In measurement index, body composition was measured by % body fat and BMI. Exercise stress test analyses were measured using ST/HR slope and QRS vector. Statistical analysis was performed using analysis of repeated ANOVA. Results of this study were as follows: In ST/HR slope, the control group showed symptoms of ischemia after nine minutes of exercise. In the rest frontal axis of the QRS vector, the control group had a tendency towards right axis deviation. In the rest horizontal amplitude of the QRS vector, the control group had a tendency to show a significant decrease, but it was increased significantly in the exercise group. These findings suggest that inactive company workers was showed a decrease of exercise capacity, early diagnosis exercise-induced ST depression, and prolonged deviation of QRS vector, but that cardiac function could be elevated in active middle aged men through regular exercise program participation.

Immediate effects of cigarette smoking on exercise in young adult smokers (젊은 성인 흡연자에게 흡연이 운동능에 미치는 즉시효과)

  • Park, In Won;Koh, Hyung Ki;Kang, Yoon Jung;Choi, Jae Sun;Yoo, Jee Hoon;Shin, Jong Wook;Lim, Seong-Yong;Choi, Byoung Whui;Seo, Seung Cheon;Na, Moon Jun;Hue, Sung Ho
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.1
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    • pp.154-161
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    • 1997
  • Background : Although the long term adverse effects of cigarette smoking on health are well known, the acute possible detrimental effects of smoking on pulmonary or cardiovascular function, especially when these systems are stressed by the metabolic demands of exercise, have not been well studied The purpose of this study is to determine the acute action of cigarette smoking on cardiopulmonary function under stress. Method : Twenty -one healthy smoking subjects were studied. Before exrecise testing, history taking, physical examination and baseline studies, including CBC, chest PA, PFT and EKG, were done. The subjects performed an incremental bicycle exercise test to exhaustion on two occasions, one without smoking and the other after smoking 5 cigarettes/h for 2 hours. All indices of P.F.T. and bicycle ergometry were compared between before and after smoking. Results : 1. $VO_2$max and $O_2$ pulse showed significant decrease in smoking day. 2. Although there were no significant differences, anaerobic threshold showed a tendency of decrease and HRmax showed that of increase in smoking day. 3. P.F.T. and respiratory indices showed no significant change io smoking day. Conclusion : Cigarette smoking has immediate adverse effect, especially on the cardiovascular system rather than the respiratory system. These results would be due to the effect of elevated HbCO and/or impaired blood flow in response to the exercise stimulus.

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Characteristic Findings of Exercise ECG Test, Perfusion SPECT and Coronary Angiography in Patients with Exercise Induced Myocardial Stunning (게이트 심근관류 SPECT상 운동 유발성 기절심근을 보이는 환자의 운동부하 심전도, 관류 SPECT 및 심혈관 조영술 소견)

  • Ahn, Byeong-Cheol;Seo, Ji-Hyoung;Bae, Jin-Ho;Jeong, Shin-Young;Park, Hun-Sik;Lee, Jae-Tae;Chae, Shung-Chul;Lee, Kyu-Bo
    • The Korean Journal of Nuclear Medicine
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    • v.38 no.3
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    • pp.225-232
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    • 2004
  • Purpose : Transient wall motion abnormality and contractile dysfunction of the left ventricle (LV) can be observed in patients with coronary artery disease due to post-stress myocardial stunning. To understand clinical characteristics of stress induced LV dysfunction, we have compared the findings of exercise stress test, myocardial perfusion SPECT and coronary angiography between subjects with and without post-stress LV dysfunction. Materials and Methods : Among subjects who underwent exercise stress test, myocardial perfusion SPECT and coronary angiography within a month of interval, we enrolled 36 patients with post-stress LV election fraction (LVEF) was $\geq5%$ lower than rest (stunning group) and 16 patients with difference of post-stress and rest LVEF was lesser than 1 %(non-stunning group) for this study. Treadmill exercise stress gated myocardial perfusion SPECT was performed with dual head SPECT camera using 740 MBq Tc-99m MIBI and coronary angiography was also performed by conventional Judkins method. Results : Stunning group had a significantly higher incidence of hypercholesterolemia than non-stunning group(45.5 vs. 7.1%, p=0.01). Stunning group also had higher incidence of diabetes mellitus and lower incidence of hypertension, but these were not statistically significant. Stunning group had larger and more severe perfusion defect in stress perfusion myocardial SPECT than non-stunning group(extent 18.2 vs. 9.2%, p=0.029; severity 13.5 vs. 6.9, p=0.040). Stunning group also had higher degree of reversibility of perfusion defect, higher incidence of positive exercise stress test and higher incidence of having severe stenosis ($80{\sim}99%$) in coronary angiography than non-stunning group, but these were not statistically significant. In stunning group, all of 4 patients without perfusion defect had significant coronary artery stenosis and had received revascularization treatment. Conclusion : Patients with post-stress LV dysfunction had larger and more severe perfusion defect and severe coronary artery stenosis than patients without post-stress LV dysfunction. All of the patients without perfusion defect in stunning group had significant coronary artery stenosis and needed revascularization. Therefore, we suggest that invasive diagnostic procedures and therapeutic interventions might be needed in patients with post-stress LV dysfunction.