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Herman Groepenhoff , Msc
Head Pulmonary Function Dpt, VU UMC, Amsterdam, NL
" During clinical exercise testing, we rely on the bicycle ergometers of Lode"

Maximal cardio pulmonary exercise testing is a proven clinically useful test when gas exchange parameters and cardio-circulatory parameters are related to (maximal) exercise tolerance. Therefore a reliable ergometer simply connectable to a metabolic chart is of great importance. In our clinic we use a.o. the Corival (ideal for children) in the function lab and the MRI Ergometer Pedal for supine position measurements during Magnetic resonance imaging from Lode BV.
Publications

Exercise stroke volume and heart rate response differ in right and left heart failure. (Groepenhoff H, Westerhof N, Jacobs W, Boonstra A, Postmus PE, Vonk-Noordegraaf A.)

Date
2010-07-12
Title journal
Exercise stroke volume and heart rate response differ in right and left heart failure.
Source
European Journal of Heart Failure

In pulmonary arterial hypertension (PAH), the exercise-induced increase in stroke volume (SV) is limited by the increase in pulmonary artery pressure. In left heart failure (LHF), systemic arterial pressure increases little during exercise, and the SV increase is limited by the left ventricle itself. These differences might be reflected by a dissimilar SV and heart rate (HR) response to exercise, which could have important therapeutic implications, for example in beta-blocker therapy. Therefore, we tested the hypothesis that SV and HR responses during exercise are different between PAH and LHF patients.

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Stroke volume response during exercise measured by acetylene uptake and MRI (Groepenhoff H, Holverda S, Marcus JT, Postmus PE, Boonstra A, Vonk-Noordegraaf A.)

Date
2007-01-28
Title journal
Stroke volume response during exercise measured by acetylene uptake and MRI
Source
Physiological Measurement

The intra-breath technique to measure acetylene absorption offers the possibility to determine augmentation of the pulmonary blood flow per heart beat (Q(C)) as an estimate of the stroke volume response during exercise. However, this method has not been compared with a validated test until now. Therefore, the aim of this study was to compare Q(C) with stroke volume (SV(MRI)) determined by magnetic resonance imaging (MRI) at rest and during exercise in healthy subjects and patients. For this purpose, ten healthy subjects and ten patients with idiopathic pulmonary arterial hypertension (iPAH) with expected impaired stoke volume response during exercise were measured by both methods. Exercise-induced changes in Q(C) and SV(MRI) were correlated in healthy controls (r = 0.75, p < 0.05). Compared to healthy controls, Q(C) increased less during exercise in iPAH patients (11 +/- 17 ml versus 33 +/- 12 ml, p < 0.05). A similar difference in stroke volume response to exercise between the two groups was measured by MRI (-0.6 +/- 8 ml versus 23 +/- 12 ml, p < 0.05, respectively). Hence, intra-breath and MRI measurements showed similar differences in exercise-induced changes in stroke volume between controls and patients. From these results it can be concluded that the intra-breath measurement of acetylene absorption might be of value as a non-invasive tool to estimate stroke volume augmentation during exercise and can detect differences in stroke volume responses between iPAH patients and healthy subjects.

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Exercise testing to estimate survival in pulmonary hypertension (Groepenhoff H, Vonk-Noordegraaf A, Boonstra A, Spreeuwenberg MD, Postmus PE, Bogaard HJ.)

Date
2008-10-01
Title journal
Exercise testing to estimate survival in pulmonary hypertension
Source
Medicine and Science in Sports and Exercise

The 6-min walk distance (6MWD) predicts survival in pulmonary hypertension (PH). The peak oxygen consumption (V O2peak) measured during a cardiopulmonary exercise test (CPET) also relates to survival in PH, and it is unknown how the prognostic information from measurements of ventilatory responses and gas exchange during CPET compares to the prognostic information obtained by the 6MWD alone. The aims of our study were to compare prognostic values of different exercise parameters in PH and to assess whether CPET adds prognostic value to the information from the 6MWD.

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