Abstract:
BACKGROUND AND PURPOSE:Cardiovascular and pulmonary factors contributing to impaired peak oxygen uptake (VO2) in patients with stroke (SP) are not well known. We assessed cardiovascular function, pulmonary gas exchange, and ventilation in SP and healthy age, gender, and activity-matched control subjects. METHODS:Ten hemiparetic SP and 10 control subjects were enrolled. Subjects completed cycle ergometry testing to assess peak and reserve VO2, carbon dioxide production, ventilation (tidal volume; breathing frequency; minute ventilation), and cardiac output. VO2, carbon dioxide production, and minute ventilation were measured throughout peak exercise recovery (off-kinetics) and at exercise onset (on-kinetics) along with heart rate during low-level exercise. RESULTS:Peak VO2 was 43% lower (P<0.001) in SP secondary to reduced peak and reserve cardiac output and minute ventilation. The impaired cardiac output reserve (P<0.001) was due to a 34% lower heart rate reserve (P=0.001). The impaired minute ventilation reserve (P=0.013) was due to a 41% lower tidal volume reserve (P=0.009). Stroke volume and breathing frequency reserve were preserved. VO2 off-kinetics were 29% slower in SP (P<0.001) and related to peak VO2 (R=-0.72, P<0.001) and peak cardiac output (R=-0.75, P<0.001) for the study group. Additionally, carbon dioxide production (P=0.016) and minute ventilation (P=0.023) off-kinetics were prolonged in SP. VO2 on-kinetics were 29% slower (P=0.031) during low-level exercise in SP. CONCLUSIONS:The impaired peak VO2 in SP is secondary to a decline in peak and reserve cardiac output and ventilation. Prolonged VO2 kinetics in SP are associated in part with deconditioning and may be mediated by reduced O2 availability and/or the rate of muscle O2 use.
journal_name
Strokejournal_title
Strokeauthors
Tomczak CR,Jelani A,Haennel RG,Haykowsky MJ,Welsh R,Manns PJdoi
10.1161/STROKEAHA.108.515346subject
Has Abstractpub_date
2008-11-01 00:00:00pages
3102-6issue
11eissn
0039-2499issn
1524-4628pii
STROKEAHA.108.515346journal_volume
39pub_type
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