Typescript (photocopy). / Digitized by Kansas Correctional Industries

An abnormal chronotropic response to exercise is a common finding following surgical repair of tetralogy of Fallot (TOF) which has generally been attributed to a putative sympathetic dysfunction. There exists little information on sympathetic function in patients operated for a congenital heart defect to support such a claim. This study used spectral analysis of heart rate (HRV) and blood pressure (BPV) variability to examine sympathovagal influences on the sinus node in 9 adolescents operated for TOF 13.0 +/- 1.12 years previously and in 8 healthy age and sex-matched control (CTRL) subjects. Continuous ECG and BP recordings were obtained under supine or seated resting positions, with or without controlled respiration at 0.20 Hz (CR); after passive 85° head-up tilt (HUT); during cycling at steady-state heart rates of 100 and 120 bpm (Ex 100, Ex 120), and after 10 and 20 minutes of passive seated recovery. (Abstract shortened by UMI.)

Aim: To determine the prognostic value of cardiopulmonary exercise testing (CPET) for major vascular surgery in South African patients. Methods: CPET has been used in Durban since October 2004 to predict cardiac risk for high-risk patients undergoing major vascular surgery. A submaximal 'anaerobic threshold' (AT) test was conducted on all high-risk patients. Patients were classified into two groups: 'low AT' where the oxygen consumption at the AT was <1 lml.kg^.min"1 for cycling or < 9ml.kg"1.mkf1 for arm cranking and 'high AT' when the patient surpassed these targets. Analysis of all in-hospital deaths following surgery was conducted by two independent assessors blinded to the CPET test result. Deaths classified as primarily 'cardiac in origin' have been used in this retrospective cohort analysis. Results: The AT measured during CPET was not a statistically significant pre-operative prognostic marker of cardiac mortality. However, the survivors of the patients with a 'low AT' may be identified by their response to increasing metabolic demand between 5 and 7 ml.kg^.min"1. Survivors were more dependent on increasing heart rate, while non-survivors were more dependent on oxygen extraction. When this information is added to the AT, CPET was the only test statistically associated with cardiac mortality, in comparison to Lee's Revised Cardiac Risk Index and the resting left ventricular ejection fraction which were not statistically associated with cardiac death. A hundred percent of patients with a positive test died of cardiac causes, while 11% of the patients with a negative test had cardiac deaths. The risk ratio associated with cardiac death following a positive test was 8.00 [95% CI 3.8-16.9]. The sensitivity was 0.25 [95% CI 0.04-0.64], the specificity was 1.00 [95% CI 0.90-1.00], the positive predictive value was 1.00 [95% CI 0.20-0.95] and the negative predictive value was 0.88 [95% CI 0.74-0.95]. Conclusions: CPET provides valuable prognostic information in our surgical population. / Thesis (M.Sc.)-University of KwaZulu-Natal, Westville, 2007.

Twelve middle aged men and women (23-59 years) participated in twelve weeks (36 sessions) of endurance swim training at an approximate intensity of 75% maximum heart rate (Karvonen Method) (14). This training resulted in improved cardiorespiratory fitness as evidenced by a significant (9.4%) increase in mean maximal oxygen uptake (liters/ min.) and a significant bradycardial response during submaximal walking. Subjects lost significant amounts of subcutaneous body fat, as measured by skinfold calipers, but experienced very little change in absolute body weight (.1 kg.) suggesting an increase in muscle weight. Data from the submaximal walking test, administered after each 12 session period of training, showed a nonlinear decline in heart rate throughout training. This, possibly, was in response to an accumulating fatigue factor brought on by a rapid increase in the amount of total work that the subjects were doing during the middle stage of training.

No description available.

Thesis (M.S. Ed.)--Virginia Polytechnic Institute and State University, 1994. / Vita. Abstract. Includes bibliographical references (leaves 69-71). Also available via the Internet.

Heart failure represents amajor cause ofmorbidity andmortality in Western society. Cardiacmyocyte loss due to apoptosis plays a significant role in the progression of heart failure. The extracellularmatrix (ECM) maintains the structural integrity of the heart and allows the transmission of electrical and mechanical signals during cardiac contraction and relaxation. Matricellular proteins, a class of non-structural ECM proteins, play a significant role in ECM homeostasis and intracellular signaling via their interactions with cell surface receptors, structural proteins, and/or soluble extracellular factors such as growth factors and cytokines. Osteopontin (OPN), also called cytokine Eta-1, is a member of the matricellular protein family. The normal heart expresses low levels of OPN. However, OPN expression increases markedly under a variety of pathophysiological conditions of the heart. Many human and transgenic mouse studies provide evidence that increased OPN expression, specifically in myocytes, is associated with increased myocyte apoptosis and myocardial dysfunction. This review summarizes OPN expression in the heart, and its role in myocyte apoptosis and myocardial function.

There is epidemiological and experimental evidence suggesting that exercise training may reduce the mortality rate from coronary heart disease, in particular the sudden death rate, and that it may improve the peak functional capacity of the heart. This thesis includes experimental work that is relevant to both these questions.

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