Predicting VO
2max
in athletes is vital for determining endurance capacity, for performance monitoring, in clinical diagnostic procedures, and for disease management. This study aimed to assess the ...most suitable equation for predicting VO
2max
in competitive cyclists. Competitive cyclists (496 males, 84 females, Caucasian, 580 total) were included in the study from 1 January 2014 to 31 December 2019. Only subjects who were actively participating in national or international competitions and who were registered competitive cyclists and part of cycling teams at the time of the measurements were included. Subjects performed an incremental test on a cycle ergometer, and VO
2max
was measured as indicated by a plateau in VO
2
. In addition, four prediction equations (the FRIEND, Storer, Fairbarn, and Jones) were used to estimate VO
2max
. The predicted VO
2max
using the FRIEND equation was in good agreement with the measured VO
2max
in male and female athletes. This was reflected by a high correlation with
r
= 0.684 for men and
r
= 0.897 for women (
p
= 0.000), with ICC = 0.568 (95% CI 0.184, 0.752) for men and ICC = 0.881 (95% CI 0.813, 0.923) for women. Total error was 1.56 and 1.48 ml/min/kg and a minimal bias of−3.6 and −1.1 ml/min/kg (men and women, respectively). Using other equations resulted in a slight decline in agreement with the measured standard. The FRIEND equation predicted VO
2max
accurately with small total error, small prediction errors, and with the smallest constant error in our study cohort, indicating the potential value of using FRIEND equation also in competitive cyclists. This equation proved to have the highest accuracy both in male and female cyclists.
Models for predicting maximal oxygen consumption (VO
) in average adults might not be suitable for athletes, especially for competitive cyclists who can have significantly higher VO
than normally ...active people. The aim of this study was to develop a clinically applicable equation for predicting VO
during cycle ergometry in competitive cyclists and to compare its accuracy to the traditional American College of Sports Medicine (ACSM) equation. Maximal cycle ergometry tests were performed in 496 male and 84 female competitive cyclists. Six predictors were initially used to model the prediction equation (power output, body weight, body height, fat mass, fat-free mass and age). Power output and body weight were the most important parameters in the model predicting VO
. Three new equations were derived: for male (VO
= 0.10 × PO - 0.60 × BW + 64.21), female cyclists (0.13 × PO - 0.83 × BW + 64.02) and the non-gender-specific formula (0.12 × PO - 0.65 × BW + 59.78). The ACSM underestimated VO
in men by 7.32 mL/min/kg (11.54%), in women by 8.24 mL/min/kg (15.04%) and in all participants by 7.45 mL/min/kg (11.99%), compared to the new equation that underestimated VO
in men by 0.12 mL/min/kg (0.19%) and in all participants by 0.65 mL/min/kg (1.04%). In female cyclists, the new equation had no relative bias. We recommend that medicine and sports practitioners adapt our proposed equations when working with competitive cyclists. Our findings demonstrate the need to evaluate prediction models for other athletes with a special focus on disciplines that demand high aerobic capacity.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Preeclampsia is associated with left ventricular (LV) geometrical and functional changes, which could be related to cardiovascular risk later in life. The purpose of our study was to evaluate ...evolution of LV dimensions and function in severe preeclamptic women from immediately post-delivery to 1 year postpartum. Twenty-five women with severe preeclampsia and 15 healthy term controls underwent standard and speckle-tracking echocardiography 1 day after delivery and 1 year postpartum. On day 1 post-delivery preeclamptic women were exposed to higher preload (p = 0.003) and afterload (p < 0.001) compared to controls. Parameter of longitudinal LV systolic function s’ was significantly lower in preeclamptic compared to control group (p = 0.017) 1 day post-delivery. Additionally, diastolic function parameters were significantly more impaired in preeclamptic compared to control group (lower e′ (p = 0.02) and higher E/e′ ratio (p = 0.003) in preeclamptic group). Larger LV mass (p = 0.03) and a trend of higher proportion of altered cardiac geometry (p = 0.061) were observed in preeclampsia 1 day post-delivery. One year after delivery both groups had comparable geometric and functional parameters with similar afterload and preload (p > 0.05, for all). In preeclamptic group systolic and diastolic functional parameters improved significantly during follow-up (p < 0.05), while no such evolution was noted in controls (> 0.05). In women with severe preeclampsia subtle cardiac functional impairment immediately post-delivery completely resolved 1 year postpartum. Observed cardiac alterations suggest intrinsic myocardial dysfunction in preeclampsia, which became unmasked or exacerbated by higher load imposed on the LV immediately post-delivery that disappeared in mid-term follow-up.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
OBJECTIVES:In women with severe preeclampsia the period immediately before and early postdelivery carries the greatest risk for cardiac decompensation due to acute changes in loading conditions. The ...authors aimed to evaluate dynamic changes in hemodynamic and echocardiographic-derived systolic and diastolic function parameters in preeclamptic women compared with healthy controls.
METHODS:Thirty women with severe preeclampsia and 30 healthy controls underwent transthoracic echocardiography 1 day before, 1 and 4 days postdelivery. Fluid responsiveness was assessed by passive leg raising.
RESULTS:Peak systolic myocardial velocities (s′) and global longitudinal strain (GLS) were significantly lower in preeclamptic group compared with controls only postdelivery (s′7.3 ± 0.8 vs. 8.3 ± 0.9 cm/s, P < 0.001; GLS−21.4 ± 2.0 vs. −23.0 ± 1.4%, P = 0.027). In addition, significant decrease in s′ after delivery was observed only in preeclamptic group (P = 0.004). For diastolic parameters there were differences both before and postdelivery in E/e′ ratio (before8.4 ± 2.16 vs. 6.7 ± 1.89, P = 0.002; postdelivery8.3 ± 1.64 vs. 6.8 ± 1.27, P = 0.003) and mitral e′ velocity (before11.0 ± 2.39 vs. 12.6 ± 1.86, P = 0.004; postdelivery11.1 ± 2.28 vs. 14.0 ± 2.40 cm/s, P < 0.001). Significant increase in left ventricular stroke volume (P = 0.005) and transmitral E velocity (P = 0.003) was observed only in control group, reflecting response to volume load after delivery. Accordingly, only the minority of preeclamptic women were fluid responsive (11 vs. 43%, P = 0.014 between groups).
CONCLUSION:Variations in cardiac parameters in healthy women seem to follow changes in loading conditions before and early after delivery. Different pattern in preeclamptic women, however, may be related to subtle myocardial dysfunction, that becomes uncovered with augmented volume load in early postpartum period.
Resting and exercise right heart catheterisation is the gold standard method to diagnose and differentiate types of pulmonary hypertension (PH). As it carries technical challenges, the question ...arises if non-invasive exercise stress echocardiography may be used as an alternative. Exercise echocardiography can unmask exercise PH, detect the early stages of left ventricular diastolic dysfunction, and, therefore, differentiate between pre- and post-capillary PH. Regardless of the underlying aetiology, a developed PH is associated with increased mortality. Parameters of overt right ventricle (RV) dysfunction, including RV dilation, reduced RV ejection fraction, and elevated right-sided filling pressures, are detectable with resting echocardiography and are associated with worse outcome. However, these measures all fail to identify occult RV dysfunction. Echocardiographic measures of RV contractile reserve during exercise echocardiography are very promising and provide incremental prognostic information on clinical outcome. In this paper, we review pulmonary haemodynamic response to exercise, briefly describe the modalities for assessing pulmonary haemodynamics, and discuss in depth the contemporary key clinical application of exercise stress echocardiography in patients with PH.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
The concept of disproportionate mitral regurgitation (dispropMR) has been introduced to identify patients with functional mitral regurgitation (MR) who benefit from percutaneous treatment. We aimed ...to examine echocardiographic characteristics behind this entity. We retrospectively included 172 consecutive patients with reduced left ventricular ejection fraction (LVEF), and more than mild MR referred to clinically indicated echocardiography. According to the proportionality ratio (effective regurgitant orifice area (EROA)/left ventricular end-diastolic volume (LVEDV)) patients were divided into dispropMR and proportionate MR (propMR) group. Potential factors which might affect proportionality definition were analyzed. 55 patients (32%) had dispropMR. Discrepant grading of MR severity was observed when using regurgitant volume (RegVol) by proximal isovelocity surface area (PISA) method or volumetric method, with significant discordance only in dispropMR (p < 0.001). Patients with dispropMR had more frequently left ventricular foreshortened images for LVEDV calculation than patients with propMR (p = 0.003), resulting in smaller LVEDV in dispropMR group. DispropMR group had more substantial dynamic variation of regurgitant flow compared to propMR. Accordingly, EROA was consistently overestimated by standard single-point PISA method compared to serial PISA method. This was more pronounced in dispropMR (bias:10.5 ± 28.3 mm
2
) compared to propMR group (bias:6.4 ± 12.8 mm
2
). DispropMR may be found in roughly one third of clinically indicated echocardiographic studies in patients with reduced LVEF and more than mild MR. EROA overestimation due to dynamic variation of regurgitant flow and LVEDV underestimation due to LV foreshortening were more frequently found in dispropMR. Our results indicate that methodological limitations of echocardiographic MR grading could not be neglected in classifying the proportionality of MR.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
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