Maximal Physical Capacity Research Articles

Machine learning for development of ECG-based prediction models for atrial fibrillation, thromboembolism and mortality in patients with heart failure

Abstract Background Heart failure (HF) is a worldwide epidemic affecting more than 64 million people. Given its massive burden both socially and economically, early identification of individuals at risk for complications is important. Purpose To test the predictive performance of non-invasive models from 12-lead digitalized electrocardiography (ECG) and cycle ergometer for adverse outcome in individuals with heart failure. Methods 598 Patients scheduled for right heart catheterization due to unexplained dyspnea were screened. All ECG recorded at admission were further analysed using the software "ECG-Precision-Analysis V-1-2023" to measure the duration of amplified p-wave (APWD at 175mm/sec, 80mm/mV) and to confirm the diagnosis of inter-atrial block. Ergometer was performed in a supine position with increasing intensity adapted to individual capacity (25 or 50W). The maximum physical capacity (Watt-max) was determined. Follow-up (FU) was scheduled at 12-,36-, 60- and 120-month after discharge with the primary endpoint as MACCE (a composite of new onset of AF, ischemic stroke and peripheral embolism) in at baseline event-free patients and the secondary endpoint as all-cause mortality in the total cohort. Three machine learning (ML) algorithms (COX regression, BSR and LASSO regression) were used to select candidate variables and establish predictive models for MACCE and all-cause mortality. Model evaluation was performed in terms of discriminatory power using C-statistics for each endpoint. Results Prediction models developed using machine learning (ML) algorithms (COX regression, BSR and LASSO regression) identified Watt-max and/or APWD as core components for MACCE and mortality prediction . APWD and Watt-max were key components of ML models for prediction of thromboembolic risk and AF (MACCE) and reached accurate diagnostic performances (C-statistics up to 0.74), moreover, another model consisted of APWD and aIAB (advanced inter-atrial block) was established to serve as a reference to ML models with moderate performance for MACCE (mean C-statistics <0.70). All ML models for prediction of all-cause mortality included Watt-max and achieved C-statistics > 0.75. Conclusions In patients with heart failure, the combination of APWD, aIAB and maximum excercice capacity allow to identify patients at risk for AF and stroke, whereas mortality is predominantly predicted by maximum exercise capacity but not APWD.Kaplan-Meier curves for MACCE/MortalitytimeROC curves for MACCE/Mortality

Are there limits to growth of tourism on the Caribbean islands? Case-study Aruba

Mass tourism is a major driver of economic growth in the Caribbean. One major trade-off of this economic growth model is the loss of natural areas due to tourism activities and increasing urbanization. Aruba is one of the most tourist intense destinations within the region with a total of 1.1 million stay-over tourists in 2019. Moreover, this island has one of the largest population densities in the Caribbean and high-speed urbanization takes place in this formerly rural island state. Therefore, this study aims to assess the islands' carrying capacity in relation to its limited land resources by means of a geospatial methodological analysis coupled with a correlation analysis between socio-economic indicators and statistics. First, the past and present drivers and characteristics of urbanization are analyzed. Second, the correlation between socio-economic indicators and the number of tourists was assessed. Third, two future scenarios were developed to assess the maximum carrying capacity. From 1986 till 2020, Aruba's built environment increased from ~29–60 km2 and translates to one-third of the island. Expansion was characterized by sprawl in the earlier years and changed to infilling in the latter. Furthermore, the results indicate that all socio-economic indicators are strongly positive correlated to tourism. Lastly, the possible maximum physical carrying capacity for yearly visitors and number of inhabitants was calculated to be ~1.7 million and 150.000, respectively. We conclude that the proposed methodological framework is robust and adequate to serve as a low budget decision-making tool for sustainable tourism development on islands.

Can quantifying the relative intensity of a person’s free-living physical activity predict how they respond to a physical activity intervention? Findings from the PACES RCT

ObjectivesTo determine whether quantifying both the absolute and relative intensity of accelerometer-assessed physical activity (PA) can inform PA interventions. We hypothesised that individuals whose free-living PA is at a low...

Does COVID-19 Affect the Exercise Capacity of Non-hospitalized Patients?

ObjectiveTo determine whether non-hospitalized adults post COVID-19 have impaired exercise capacity.DesignRetrospective analysis.SettingCardiovascular outpatients unit in Instituto Cardiovascular de Rosario, Argentina.PatientsEighty non-hospitalized patients post-infection by COVID-19.InterventionsParticipants completed an ergometry pre and post COVID-19 infection.Main outcome measuresThe study's main variables were the metabolic equivalents of task (METs) and the indirect peak oxygen consumption (VO2 peak).ResultsThe median of METs was 11.7 (9.4-14.8) and 11.7 (11-11.7) in pre and post ergometry, respectively, (p = 0.022). The median VO2 (mL/Kg/min) was 21857 (16938-32761) and 21699 (17004-26467) in pre and post ergometry, respectively, without significant differences.ConclusionsWe found slight differences in maximal physical capacity evaluated through exercise testing in non-hospitalized patients by COVID-19.

Assessing Energy Expenditure in Female Healthcare Workers in a University Hospital.

The assessment of energy expenditure (EE) at workplaces maintains a central topic in occupational health due to increasing work-related issues. Today 80% of employees in the healthcare system are women. Limited research concerning their physical activity at work is available. The purpose of the study was the investigation of body composition, maximum physical capacity and quantification of physical work activity for female healthcare workers under real-time conditions. Occupational physical activity (PA) of 33 female healthcare workers in a university hospital was quantified. Health associate professionals (HAP), health professionals (HP), and females working from cleaners and helpers (CH) department participated. All underwent cardio pulmonary exercise test. For every working task VO2, VCO2 and RER were measured and EE was calculated individually for each task. Forty-two different working tasks were identified and grouped in seven categories to compare physical activity (PA): 'office and laboratory work', 'bedside patient care', 'instrument reprocessing, packing boxes', 'walking with patient, or alone', 'pushing carts or wheelchairs', 'strenuous cleaning in bent posture' and 'lifting heavy boxes, weights or items'. By comparing groups of healthcare workers, CH and HAP spent significant (p < 0.01) more EE (in kcal/min) 3.9 resp. 3.2 than HP 2.5. Light PA e.g. office and laboratory work (2.7 ± 0.6) and bedside patient care (2.9 ± 0.7) were accomplished by HP and HAP while HAP and CH performed moderate PA such as 'packing boxes' (3.6 ± 0.8), 'pushing carts' and 'strenuous cleaning' (4.7 ± 0.9). Work performed by CH and HAP, i.e. 'strenuous cleaning' and 'lifting heavy items' showed highest kcal per kg Fat Free Mass (FFM) per hour with 5.80 [4.05-7.81] and 6.94 [5.18-9.03] kcal/kgFFM/h. Our findings lend preliminary support to the hypothesis that the majority of activities in female healthcare workers were of low and moderate PA and can be accomplished by middle aged and even older female workers. CH performed tasks with heavy physical activities (PA) like cleaning and lifting heavy weights. HAP performed light/moderate PA below their maximum physical capacity.

Including rest allowance in mixed-model assembly lines

Ergonomics has a significant impact on productivity and human safety in manual assembly lines. For this reason, several studies in recent years have proposed including ergonomics in assembly lines. However, most works are focused on simple assembly lines, while only a few studies exist for mixed-model assembly lines (MMALs). Thus, in this paper, we propose a new methodological approach to include physical fatigue and rest allowance (RA) as ergonomic parameters in MMAL problems. For the balancing problem, we propose a linear mathematical model that minimises the cycle time by including RA. For the sequencing decision, we develop a heuristic approach that assigns workers to workstations according to the workers’ age and their related maximum physical capacity. Then, we propose a linear sequencing model that minimises the work-overload by also evaluating RA to assign each worker according to her or his features. Finally, to complete the study, we test the mathematical models in a real case application and provide a detailed discussion of the results to highlight the benefits we can achieve with this approach.

PERSPECTIVES FOR THE APPLICATION OF VARIOUS FIRE-SAFE GAS MEDIA ON THE INHABITED SEALED OBJECTS OF THE NAVY

Introduction. The need to ensure trouble-free operation of inhabited sealed objects of the Navy requires continuous improvement of technologies to increase their fire safety. Such technologies include the creation of hypoxic gas media at facilities that reduce the risk of fires and ensure the possibility of personnel staying in them. The purpose of the work is a comparative assessment of changes in the maximum human working capacity during continuous stay in various normobaric hypoxic environments, promising to increase the fire safety of sealed inhabited objects of the Navy. Materials and methods. In the 1st series of studies, 100 daily sealing of 6 male volunteers (28–53 years old) in controlled hypoxic environments was carried out: [O2] in the premises of permanent residence — 18–19%, periodic (4 hours per day) stay — 16–17%/ In the 2nd series of studies, 6 male volunteers (age 25–51 years) were continuously in argon-containing gas media with [O2]=13,5–14,5%, [Ar]=30–35% for 60 days. During the studies, the dynamics of the mental (operator) and maximum physical working capacity of the subjects were evaluated. Results. Stay in hypoxic environments was accompanied by a decrease in the working capacity of volunteers. The relative degree of negative changes in mental performance in group 1 did not exceed –7%, in group 2 — –10% of the initial level; the maximum decrease in physical performance in group 1 was on average about — –11%, in group 2 — –17% compared with the initial state, which does not go beyond the permissible limits. Conclusion. The introduction of tested gaseous media at naval facilities is promising. The choice of the composition of the gas mixture should be determined by the degree of risk of fires at a particular facility, the technical capabilities of creating and maintaining a hypoxic environment of optimal composition, the number and state of health of the crew.

Influence of exogenous melatonin on the oxidative status and the state of peroxidation of proteins in a rat model of alimentary obesity

Not only lipids, but also proteins are exposed to the action of reactive oxygen species (ROS). Oxidative modification of proteins (PBS) leads to a change in their native conformation with the formation of large aggregates, it causes inactivation of enzymes, disrupts the metabolism and functioning of cells. In addition, there is a growing interest in studying the hormone of the pineal gland called melatonin, as well as its synthetic analogues as the leading protection factors in the oxidative stress conditioned by disturbed physiological rhythms, including obesity. The peculiarities of protein peroxidation in the case of alimentary obesity, as well as the conditions affecting to this process, in contrast to lipid peroxidation (LPO), have not been studied sufficiently, that has determined the purpose of this study.&#x0D; Aim. To evaluate the effect of exogenous melatonin on the oxidative status and features of PBS in rats with alimentary obesity.&#x0D; Methods. The study was conducted on 27 white Wistar male rats with body weight 160180 grams. Animals were divided into 3 series of 9 rats in each: 1 series intact animals; 2 series animals with alimentary obesity, followed by the introduction of 0,9% sodium chloride solution in a volume of 2 ml for 12 days; 3 series animals with alimentary obesity followed by melatonin administration at a dose of 2 mg / kg rats for 12 days. Alimentary obesity was reproduced by feeding animals with high-calorie carbohydrate-fatty food, consisting of a laboratory feed "Assortment Agro" (42.5%), butter (25%) and sweet condensed milk (32.5%) for seven weeks. The maximum physical working capacity and resistance of rats to severe hypobaric hypoxia were determined. PBS was determined by the method of R. Levine in the modification of E.E. Dubinina. In addition, the lipid peroxidation marker TBA-reactive products (malonic dialdehyde MDA) was determined.&#x0D; Results. It has been established that the PBS in alimentary obesity is not specific, it is reflected in the increase in the areas of absorption of light from both the visible and ultraviolet of aldehyde and ketondinitrophenylhydrazones. In parallel with this, there was a marked increase in the concentration of TBA-reactive products in the blood serum in this pathology, as well as a significant decrease in the resistance of rats to hypobaric hypoxic hypoxia and maximum physical activity. The daily administration of a 2 mg/kg melatonin suspension to rats with alimentary obesity for 12 days leads to a significant decrease in the concentration of TBA-reactive products, however, the PBS is not significantly affected.&#x0D; Conclusion. Alimentary obesity in rats, simulated by the maintenance of animals on a high-calorie carbohydrate-fat diet, leads to an increase in the proportion of visceral fat in the body, an increase in the activity of PBS in the form of an increase in the level of carbonyl derivatives, a significant increase in the concentration of MDA, and a significant decrease in the stability of rats to hypobaric hypoxic hypoxia and maximum physical activity. When a melatonin suspension was administered at a dose of 2 mg/kg for 12 days, a stable high level of carbonyl derivatives was observed, in comparison with the intact series, which was explained by the need to use a greater concentration of the drug to increase its exposure time, which requires further study.

The Impact of Firefighter Physical Fitness on Job Performance: A Review of the Factors That Influence Fire Suppression Safety and Success

Purpose: The objective of this review was to analyze the physiological impact of fire suppression on the human body. Design: The literature review included studies focused on workload requirements for common firefighting tasks, effect of health status on the firefighting profession, and attempts to establish a minimum physiological workload capacity for successful performance of firefighting. Findings: The existing literature provides evidence of the high degree of physiological stress that firefighters are under during fire suppression tasks and the great degree of maximal physical capacity that firefighting often requires. Firefighters often operate close to maximal aerobic capacity while performing tasks common to the profession. This is especially true due to the added physiological stress placed on the human body while wearing personal protective equipment during firefighting. Conclusions: Future investigations are necessary to further explore markers of physiological stress during firefighting and the impact that it may have on the ability to withstand the development of disease as well as fire suppression safety. Using completion time of fire suppression tasks as a criterion of success may be an important consideration in addition to the physiological requirements of the occupation when assessing the appropriateness of an individual to be a firefighter. An important future consideration is the effect that fire suppression activities may have on reaction time in critical situations in which life-and-death decisions must be made.

Pulmonary and muscle profile in pneumosepsis: A temporal analysis of inflammatory markers

In sepsis, greater understanding of the inflammatory mechanism involved would provide insights into the condition and into its extension to the muscular apparatus in critically ill patients. Therefore, this study evaluates the inflammatory profile of pneumosepsis induced by Klebsiella pneumoniae (K.p.) in lungs and skeletal muscles during the first 72 h. Male BALB/c mice were divided into 4 groups, submitted to intratracheal inoculation of K.p. at a concentration of 2 × 108 (PS) or PBS, and assessed after 24 (PS24), 48 (PS48) and 72 (PS72) hours. The Maximum Physical Capacity Test (MPCT) was performed before and after induction. Pulmonary inflammation was assessed by total cell number, nitric oxide levels (NOx), IL-1β and TNF-α levels in bronchoalveolar lavage fluid (BALF); inflammation and muscle trophism were evaluated by the levels of TNF-α, IL-6, TGF-β and BDNF by ELISA and NF-κB by western blotting in muscle tissue. Cells and colony forming units (CFU) were also analyzed in blood samples. The PS groups showed an increase in total cells in the BALF (p < 0.05), as well in the number of granulocytes in the blood (p < 0.05) and a decrease in performance in the MPCT (p < 0.05). NOx levels showed significant increase in PS72, when compared to Control group (p = 0.03). The PS24 showed a significant increase lung in TNF-α levels (p < 0.001) and in CFU (p = 0.013). We observed an increase in muscular IL-6 and nuclear NF-κB levels in PS24 group, when compared to PS48 and Control groups (p < 0.05). Nevertheless, mild signs of injury in the skeletal muscle tissue does not support the idea of an early muscular injury in this experimental model, suggesting that the low performance of the animals during the MPCT may be related to lung inflammation.

EVALUATION OF PHYSICAL EXERCISE BY SWIMMING PREVIOUSLY TO MYOCARDIAL INFARCTION

Physical exercise prior to myocardial infarction (MI) protects against the IM scar, prevents cardiac remodeling and attenuates systolic dysfunction and diastolic activity in rats. Evaluate the influence of physical training by swimming, performed prior to MI, on the growth of cardiac masses, pulmonary and hepatic water content. Characterize the echocardiographic changes indicative of cardioprotection induced by physical training prior to myocardial infarction. Young rats weighing between 170 and 190 grams, from the Experimental Models Development Center (CEDEME) of the Federal University of São Paulo, were used. The animals were kept in boxes with water and rations in a temperature controlled environment. They were distributed in four experimental groups: non‐infarcted sedentary (SS); Sedentary infarcted (IMS); Trained non‐infarcted (SE); Infarcted Training (IME) The animals were submitted to a period of adaptation to the swimming exercise, later those belonging to the SE and IME groups swam for 90 minutes, this time was maintained until five weeks were completed. After this period the maximum physical capacity (MCF) was again evaluated and then the rats were submitted to myocardial infarction (MI) surgery. The method of production of IM was based on the work of Johns and Olson (1954). After three weeks of infarction the animals were submitted to Doppler echocardiography and were sacrificed for the analysis of the wet and dry weight of the heart, lungs and liver. The data were statistically evaluated, one‐way ANOVA followed by Tukey's test, and significant values of (p&lt;0,05) were considered. After the training period prior to MI, the animals exercised SE (2,317 ± 275 seconds) and IME (3,104 ± 281 seconds) had an increase (p ≤ 0.001) in MCF compared to SS sedentary animals (378 ± 43 seconds) and IMS (341 ± 25 seconds), respectively. These results indicate that the protocol was effective in increasing the cardiorespiratory capacity of the exercised animals. The atrial masses of the infarcted animals were higher than those of the non‐infarcted animals (p ≤ 0.001). The right ventricular (RV) mass values of SE, IMS and IME animals were higher than the values for the SS group (p ≤ 0.001). There was hypertrophy (12%) of the left ventricle (LV) of the SE rats in relation to the SS (p = 0.008). The results of the IMS and IME groups related to the cardiac morphology indicated significant LV dilation and decreased LV wall thickness (p ≤ 0.001) in relation to SS and SE animals. No significant differences were observed in the comparisons of aortic diameters, left atrial and LV posterior wall thickness between groups. The water contents of the lungs and liver did not differ significantly between the four experimental groups. The results related to the systolic function indicated that there was a significant loss (p ≤ 0.001) of the shortening fraction and the shortening fraction of the transverse area indicating clear systolic dysfunction, not prevented by physical exercise. Values for diastolic function in infarcted animals were significantly worse than those recorded in non‐infarcted animals (p&lt;0,05). The protocol of physical training per swimming, imposed prior to MI, did not prevent the cardiac remodeling of infarcted rats and does not prevent cardiac remodeling or systolic and diastolic dysfunction evaluated by Doppler echocardiography.This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Changes in Total Cardiac Output and Oxygen Extraction During Exercise in Patients Supported With an HVAD Left Ventricular Assist Device.

Following implantation of a left ventricular assist device (LVAD), acceptable functional performance is now being achieved; however, peak VO2 and peak work load (watts) remain considerably limited. Maximum physical capacity is essentially dependent on generated cardiac output (CO) and arteriovenous oxygen difference (avDO2 ). We investigated the changes in CO and avDO2 during exercise in LVAD patients with an HVAD pump (HeartWare Inc., Framingham, MA, USA). Approximately 6 weeks after implantation, 20 patients (100% male, 60.8 ± 7.3 years old, BMI 25.7 ± 3.3) underwent a six-minute walk test (6MWT), a cardiopulmonary exercise test (CPET), and noninvasive hemodynamic measurement. The mean six-minute walking distance (6MWD) was 403 m (68% of predicted), and mean peak VO2 was 10.9 mL/kg/min (39% of predicted). Mean total CO improved from 3.8 L at rest to 7.0 L at maximum exercise. The mean avDO2 increased from 7.4 mL/dL (44% of oxygen content) at rest to 13.2 mL/dL (75% of oxygen content) at maximum exercise. There was a significant increase in both total CO (P < 0.01) and avDO2 (P < 0.05) between rest and sub-maximum exercise. As exercise levels increased, however, no further significant changes were achieved. Long-term studies, especially in combination with exercise programs, would be desirable in order to observe the development of these parameters.

Oxygen Consumption (V\u2019O2) and physical Strainas measured by the occupational activity of cleaning personnel

BackgroundThe aim of the study was to determine the physical effort and energy expenditure needed over a working period of 45–60 min, specifically for the occupational activity of cleaning. The effort was demonstrated in absolute terms (V’O2), in relation to the involved person’s maximum physical capacity (peak V’O2) and in relation to the individual aerobic-anaerobic threshold (V’O2 at VT1, the point when lactate starts to accumulate but can be cleared). In addition to this, the aim was to verify the suitability of portable ergospirometry in determining the occupational workload in a real-life setting.MethodsThirty-five cleaners performed a bicycle ergospirometry to determine their maximum physical capacity (peak V’O2 = L/min) and their aerobic-anaerobic threshold (V’O2 at the Ventilatory Threshold 1 [VT1]). This was followed by portable ergospirometry lasting 45–60 min while pursuing regular cleaning activities.ResultsPerformance V’O2 (the average oxygen consumption over 45–60 min of work- time) was 1.06 L/min or 4.4 METs. This was scarcely lower than the individual V’O2 at VT1 and approached 45% of the maximum physical capacity (peak V’O2). In addition, there was positive feedback regarding the wearability of the portable device. The dropout rate was low.ConclusionThe occupational activity of cleaning was defined as a “committed activity”, performed close to the upper limit of the continuous physical capacity (approaching V’O2 at VT1). The positive feedback and a low dropout rate proved good acceptance of portable ergospirometry in this field of work over a 45–60 min period.

Kinetics study of platinum and base metals precipitation in gas\u2013liquid chloride system

The use of dissolved sulphur from gaseous phase was tested for its ability to precipitate platinum ions in chloride system with alterations in the parameters such as metal ion concentration, hydrochloric acid concentration, pressure and temperature. The precipitation process was analysed on the basis of mass transfer coefficient, diffusivity models and also by absorption kinetic models. The maximum physical and reactive absorption capacity for sulphur dioxide was found to be 0.015 and 0.018 mol/L, respectively, at 298.15 K and 1.125 bars in a short contact time of 10 min. Based on the sulphur dioxide solubility data in gas–liquid system for both physical and reactive absorption conditions, the introduction of sulphur atoms in the chloride system was achieved. The mass transfer coefficients obtained for all metal ions were in the range 0.10–0.26 min−1, while the diffusivity of SO2 at different temperatures and pressures was found to be in the range (2.36–3.43) × 10−9 and (1.36–2.22) × 10−9 m2s−1, respectively. Thermodynamic parameters such as the changes in Gibbs free energy, enthalpy and entropy were also evaluated. The results indicated that the precipitation of platinum and base metals in gas–liquid (G–L) chloride system was an endothermic process.

Abstract P129: Impact of Regular Physical Activity on Prognosis After Myocardial Infarction: The OACIS Study

Introduction: It has been demonstrated that regular physical activities improve physical capacities and prognosis in survivor patients with acute myocardial infarction (AMI), especially in well-designed, relatively small patients cohorts. However, impacts of regular physical activity on prognosis are not fully elucidated in large scale, real-world settings because of varieties of confounding factors. Hypothesis: We assessed the hypothesis that regular physical activity at 3-month after AMI is an independent predictor for 5-year survival in a large cohort of post-MI patients registered in the Osaka Acute Coronary Insufficiency Study (OACIS). Methods: The OACIS is a prospective, multicenter, observational study enrolling consecutive patients with AMI at 25 collaborating hospitals in the Osaka region of Japan. Among 8957 patients registered in the OACIS, 5218 patients who reported physical activities at 3-month after MI were enrolled and were followed for 5 years. Multivariate Cox regression was used with the following variables as covariates: age, gender, BMI, HT, DM, dyslipidemia, smoking, ST-elevation MI, NYHA at 3-month after MI, reperfusion therapy, multivessel disease, depression status by SDS score, living alone, and beta-blocker, statin, antiplatelet agent, ACEI/ARB, calcium channel blocker, and diuretics therapy. Results: Regular physical activity at 3-month after MI were seen 1180 patients (22.8%, total n=5170). Cumulative mortality at 5-year after MI was 3.5%, which was lower than that in the patients without regular physical activity (3990 patients, 7.9% log-rank p&lt;0.001). However. the difference was not statistically significant in the multivariate analysis (adjusted HR 0.66, 95%CI 0.38-1.07, p=0.088). Cumulative mortality at 5-year after MI was 10.9%, which was highest (log-rank p&lt;0.001, total n=5218) in lowest quartile of maximum physical capacity (Q1: medium 4.5 Mets, n=1911) compared to 4.7% in the Q2 (median 5.5 Mets, n=681), 3.1% in the Q3 (median 6.5 Mets, n=1261), and 2.7% in the Q4 (median 7.5 Mets, n=1365). Cumulative mortality at 5-year after MI was highest (9.9%) in the patients’ activity changed from active to inactive after MI and was lowest (3.1%) in those changed from inactive to active (log-rank p&lt;0.001, total n=5204). Factors which related to start regular exercise after MI are male (OR 1.91), statin (1.59), and beta-blocker (1.33), whereas to give up was NYHA&gt;2 (OR 0.36, 95%CI 0.23-0.55, p=0.001). Frequency of cardiac death was higher in the patients without regular physical activity than with regular physical activity. Conclusion: Regular physical activity apparently related to better prognosis after AMI, but was not an independent predictor for 5-year mortality.

Les activités de la vie quotidienne du patient cardiaque : étude monocentrique

BackgroundThe main aim of cardiac rehabilitation is for the patient to sustain physical activity at home. The daily living activities (DLA) are important to take into account. Aim of the studyAnalyze the DLA of patients in CR. Patients and methodsOne thousand seven hundred and eighty patients (mean age: 60.9±11 years) followed a CR programme between 2010 and 2015. They were tested for several DLA with their cardiac frequency (CF). The observed CF was included in the Karvonen's formula, used for the prescription of physical activity. ResultsThe coefficient of Karvonen was situated between 0.54 to 0.69, which was compatible with the prescribed physical training. Nevertheless, when the maximal exercise capacity was less than 5 METs, the coefficients were higher (0.53–0.89). ConclusionIt was useful to test the cardiac patients for DLA during a CR programme. The use of Karvonen's formula allowed to compare these exercises with recommended physical training. We must be prudent when the maximal physical capacity is less than 5 METs.

Accelerometry-based monitoring of daily physical activity in children with juvenile idiopathic arthritis

Objectives: Juvenile idiopathic arthritis (JIA) may cause functional impairment, reduced participation in physical activity (PA) and, over time, physical deconditioning. The aim of this study was to objectively monitor daily free-living PA in 10–16–year-old children with JIA using accelerometry with regard to disease activity and physical variables and to compare the data with those from healthy age- and gender-matched controls.Method: Patients underwent an evaluation of disease activity, functional ability, physical capacity, and pain. Accelerometer monitoring was assessed using the GT1M ActiGraph. Normative data from two major studies on PA in Danish schoolchildren were used for comparison.Results: Data of accelerometry were available for 61 JIA patients and 2055 healthy controls. Of the JIA patients, 57% showed below-average values of maximal physical capacity (fitness level). JIA patients showed low disease activity and pain and were physically well functioning. Accelerometer counts were lower in JIA patients than in controls. Accelerometer measurements were negatively correlated with disease activity, erythrocyte sedimentation rate (ESR), and number of joints with swelling and/or limited range of motion (ROM). No correlation was found between PA and pain scores, functional ability, and hypermobility. Patients with involvement of ankles or hips demonstrated significantly lower levels of PA.Conclusions: Children with JIA are less physically active and have lower physical capacity and fitness than their age- and gender-matched healthy peers despite good disease control. The involvement of hips or ankles is associated with lower PA.

Oito semanas de treinamento intervalado na doença vascular periférica: um estudo de caso

Introduction: The interval exercise is characterized by periods of high intensity, followed by periods of moderate intensity to recover, leading to benefits in muscle and endothelial functions, therefore, being an alternative treatment for peripheral vascular disease.Objective: This study aimed to observe the effects of eight weeks of interval exercise in the sub maximum physical capacity on a patient with peripheral vascular disease.Case Description: A case study was performed with a male patient, seventy years old, with normal body mass index (24.7 kg/m²), smoker, sedentary and diabetic (insulin dependent), being diagnosed with peripheral vascular disease for a year. This study was performed for eight weeks with the application of a high-intensity walking interval training and strength exercises. After eight weeksof treatment the patient decreased his resting heart rate and subjective sensation of tiredness, increased the distance in the 6-minutewalking test in 24%, endured greater training intensity and increased the “sit down and get up” test score.Conclusion: The interval training associated to strength training improved the aerobic and anaerobic capacities of the patient, and may be a good alternative in the treatment of peripheral vascular disease.

(814) - Prognostic Value of Multislice Computed Tomography Coronary Angiography in Cardiac Transplant Recipients

s S297 Methods: Retrospective data from 27 heart transplant patients who underwent endomyocardial biopsy, cardiac diastolic function evaluation by echocardiography at rest and maximum physical capacity evaluation by ergospirometry were collected and analysed in a double-blind trial. Also, it was obtained myocardial biopsy of 10 control patients from a previous study. No other data was obtained from them. In order to realize the histological analysis, slides were stained by picrosirius-polarization (quantitative analysis of collagen). The picrosirius-polarization stained slides were scanned and transferred to a software to quantify the area of fibrosis. It was determined these images would be obtained from 40x magnification and from well distributed and noncoincident microscopic fields, with over 50% of tissue area and without large arterioles, pericardium or endocardium. Five to ten photos per slide were obtained, totalizing an area between 0.46mm2 and 0.92mm2. Afterwards, a statistical data analysis was performed correlating the area of fibrosis with the other data of the transplanted patients. The results were considered significant at p-value inferior to 0.05. Results: It was observed a percentage of 7,43% of fibrosis from the transplanted patients, and a percentage of 1,99% of fibrosis in the control patients. The percentage of fibrosis was considered significant in the transplanted patients (p= 0,037 in Kolmogorov-Sminov test, and p= 0,000 in Shapiro-Wilk test), and considered significant in the control group by Shapiro-Wilk test (p= 0,001). The correlation of fibrosis area and data of diastolic cardiac function (E/E’) and physical capacity (mean VO2 after six minutes, max VO2) for each transplanted patient resulted in significance values all above 0,05. Conclusion: The presence of fibrosis in the myocardial tissue in heart transplant patients was considered significant in comparison with the control group. However, it was not possible to establish a correlation of the area of fibrosis and the diastolic heart dysfunction and physical capacity in transplanted patients.

(817) - Cardiac Allograft Vasculopathy Assessed By Quantitative Coronary Angiography: A Single Center Prospective Study

s S297 Methods: Retrospective data from 27 heart transplant patients who underwent endomyocardial biopsy, cardiac diastolic function evaluation by echocardiography at rest and maximum physical capacity evaluation by ergospirometry were collected and analysed in a double-blind trial. Also, it was obtained myocardial biopsy of 10 control patients from a previous study. No other data was obtained from them. In order to realize the histological analysis, slides were stained by picrosirius-polarization (quantitative analysis of collagen). The picrosirius-polarization stained slides were scanned and transferred to a software to quantify the area of fibrosis. It was determined these images would be obtained from 40x magnification and from well distributed and noncoincident microscopic fields, with over 50% of tissue area and without large arterioles, pericardium or endocardium. Five to ten photos per slide were obtained, totalizing an area between 0.46mm2 and 0.92mm2. Afterwards, a statistical data analysis was performed correlating the area of fibrosis with the other data of the transplanted patients. The results were considered significant at p-value inferior to 0.05. Results: It was observed a percentage of 7,43% of fibrosis from the transplanted patients, and a percentage of 1,99% of fibrosis in the control patients. The percentage of fibrosis was considered significant in the transplanted patients (p= 0,037 in Kolmogorov-Sminov test, and p= 0,000 in Shapiro-Wilk test), and considered significant in the control group by Shapiro-Wilk test (p= 0,001). The correlation of fibrosis area and data of diastolic cardiac function (E/E’) and physical capacity (mean VO2 after six minutes, max VO2) for each transplanted patient resulted in significance values all above 0,05. Conclusion: The presence of fibrosis in the myocardial tissue in heart transplant patients was considered significant in comparison with the control group. However, it was not possible to establish a correlation of the area of fibrosis and the diastolic heart dysfunction and physical capacity in transplanted patients.