Category Archives: Abstracts

Yang X; Department of Cardiology, Hebei Province, 056002, China.
Liang J; Li Y; Miao J; Xu Y; Li W

BMC Cardiovascular Disorders. 26(1), 2026 May 23.

BACKGROUND: High-intensity interval training (HIIT) is an effective
exercise modality in cardiac rehabilitation; however, participation in
conventional centre-based programs remains suboptimal due to barriers such
as limited accessibility and adherence. Mobile health (mHealth)
technologies may improve accessibility and supervision of exercise
training. While previous studies have primarily focused on training
modality, evidence comparing different delivery models of HIIT-based
cardiac rehabilitation remains limited. This study aimed to compare the
effectiveness and safety of mHealth-supported versus centre-based delivery
of a standardized HIIT cardiac rehabilitation program in patients with
stable coronary heart disease (CHD).

METHODS: Between December 2024 and April 2025, 98 adults with stable CHD
eligible for Phase II cardiac rehabilitation were enrolled and randomly
assigned to either the control group (n = 49) or the intervention group (n
= 49). Both groups performed the same standardized HIIT protocol; the
control group received supervised centre-based rehabilitation, whereas the
intervention group performed mHealth-supported home-based training with
real-time monitoring and individualized feedback via the Xin’ankang
mHealth platform. Primary outcomes included the six-minute walk distance
(6MWD), cardiopulmonary exercise testing (CPET) parameters, and SF-36
quality of life scores. Secondary outcomes included anxiety, depression,
and sleep quality.

RESULTS: Baseline characteristics were generally comparable between
groups, although minor differences were observed in certain SF-36 domains.
After adjustment for baseline values, the intervention group demonstrated
significant improvements compared to the control group in sleep quality
scores (3.17 +/- 2.09 vs. 4.83 +/- 2.09), peak METs (5.83 +/- 0.09 vs.
4.94 +/- 0.09), anaerobic threshold METs (4.29 +/- 0.07 vs. 3.53 +/-
0.07), peak VO2 (20.12 +/- 0.30 vs. 16.70 +/- 0.30 ml/kg/min), and 6MWD
(563.83 +/- 3.21 vs. 531.49 +/- 3.21 m) (all P < 0.05). Improvements in
SF-36 scores were observed in several domains, although no significant
difference was found in vitality or mental health. Subgroup analyses
revealed consistent improvements across age groups, while a sex-specific
difference was observed for changes in VO2 peak.

CONCLUSION: Compared with centre-based delivery of the same HIIT program,
mHealth-supported HIIT was associated with greater improvements in
cardiopulmonary function, exercise capacity, and quality of life in
patients with CHD. These findings suggest that delivery modality may
influence the effectiveness of HIIT-based cardiac rehabilitation.

Cardiac Rehabilitation for Cardiovascular Risk Modification in Patients With Rheumatoid Arthritis and Hypertension: A Randomized Controlled Trial.

Kutluca A; Kayseri City Training and Research Hospital, Kayseri, Turkiye.
Sutbeyaz ST; Calis HT; Demirelli S; Citil E

International Journal of Rheumatic Diseases. 29(7):e70793, 2026 Jul.

OBJECTIVE: Patients with rheumatoid arthritis (RA) have an increased risk
of cardiovascular disease, particularly when hypertension coexists.
However, evidence regarding the role of cardiac rehabilitation (CR) in
this high-risk population remains limited. In this randomized controlled
trial, the effects of a structured CR program on estimated cardiovascular
risk, ambulatory blood pressure, and cardiorespiratory fitness were
evaluated in patients with RA and hypertension.

METHODS: In this single-center randomized controlled trial, 50 patients
with RA and hypertension were randomly assigned (1:1) to a 6-week
supervised CR program or usual care. The intervention included supervised
aerobic, resistance, and flexibility training together with weekly
educational sessions. Outcomes were assessed at baseline and at 6, 12, and
24 weeks by blinded evaluators. The primary outcome was estimated 10-year
cardiovascular risk assessed using the Framingham Risk Score (FRS), with
QRISK3 analyzed as a supportive risk measure. Secondary outcomes included
24-h ambulatory systolic blood pressure measured by ambulatory blood
pressure monitoring (ABPM), cardiorespiratory fitness assessed by
treadmill cardiopulmonary exercise testing (VO2max), and rheumatoid
arthritis disease activity (DAS28-CRP). Longitudinal changes were analyzed
using linear mixed-effects models according to the intention-to-treat
principle.

RESULTS: Linear mixed-effects modeling demonstrated a significant group x
time interaction for FRS (p < 0.001). At Week 24, the between-group
difference in FRS was -5.02 points (95% CI -8.60 to -1.44; p = 0.007).
QRISK3 showed a similar directional reduction but did not reach
statistical significance at Week 24 (-5.77 points; 95% CI -12.54 to 1.01;
p = 0.094). Significant group x time interactions were also observed for
24-h ambulatory systolic blood pressure (p < 0.001) and VO2max (p <
0.001). At Week 24, the between-group difference was -9.70 mmHg for
ambulatory systolic blood pressure and + 4.90 mL.kg-1.min-1 for VO2max.
Disease activity remained within the remission range throughout follow-up.

CONCLUSION: In selected patients with clinically stable rheumatoid
arthritis and coexisting hypertension who were receiving stable
pharmacologic therapy and were able to participate in supervised exercise,
a structured cardiac rehabilitation program was associated with
improvements in estimated cardiovascular risk profiles, ambulatory
systolic blood pressure, and cardiorespiratory fitness without worsening
disease activity. These findings support further evaluation of cardiac
rehabilitation as an adjunctive strategy for cardiovascular risk
management in a selected cardiometabolically high-risk rheumatoid
arthritis population with hypertension.

Comparative assessments of the COSMED adaptive mixing chamber versus breath-by-breath methods for oxygen uptake measurements in recreationally active adults.

Borrani F; Institute of Sport Sciences,Lausanne, Switzerland.
Conedera L; Finel L; Daucourt C; et al

Journal of Applied Physiology. 141(2):326-336, 2026 Aug 01.

Background and aims
Respiratory gas exchange during cardiopulmonary exercise testing (CPET) is
commonly measured using either a mixing chamber (MC) or a breath-by-breath
(BxB) technique. MC measurements reduce the impact of erratic ventilatory
patterns, thereby improving the accuracy of oxygen uptake ([Formula: see
text]) values, but often lack adequate temporal resolution for ventilatory
thresholds (VTs) determination. Accordingly, BxB is preferred when both
[Formula: see text] and VTs determination are sought simultaneously.
Recently, an adaptive mixing chamber (aMC) with high temporal resolution
was developed. The aims of this study were to examine the concordance of
aMC- and BxB-derived gas exchange data and to determine if the aMC
provides adequate temporal resolution for the assessment of VTs.
Methods
Fourteen healthy, recreationally active individuals (7 females, 7 males; 23.6 +/-
1.4 yr; 171.8 +/- 9.0 cm; 67.9 +/- 11.1 kg) performed a maximal CPET on a
treadmill with gas exchanges being measured simultaneously using BxB and
aMC techniques.
Results
Compared with BxB measurement, [Formula: see text] values
at peak effort were 5.0 +/- 7.8% lower using the aMC (P = 0.0419). Similar
bias was observed for [Formula: see text] values obtained at submaximal
workloads. Notably, the aMC provided adequate temporal resolution to
identify VTs among all participants in whom they could be measured with
confidence using BxB (n = 13/14). The aMC provides consistently and
reproducibly lower [Formula: see text] values compared with BxB
acquisition and provides adequate temporal resolution to determine VTs
during incremental effort CPET. This newly developed technology appears to
integrate the well-established strengths of both conventional MC and BxB
gas exchange measurement techniques.
Conclusons
NEW & NOTEWORTHY COSMED recently
developed an adaptive mixing chamber (aMC) designed to pair the accuracy
of traditional mixing chambers with improved temporal resolution. This
study establishes the agreement between the aMC and breath-by-breath (BxB)
systems and demonstrates that the aMC consistently enabled ventilatory
threshold detection whenever BxB did. These findings indicate that the aMC
retains optimal gas-exchange measurement quality while enabling reliable
ventilatory threshold identification.

Lung function and ventilatory response during high-intensity treadmill walking in adults with cerebral palsy: a cross-sectional study.

Lundgaard E; Oslo Metropolitan University, Oslo, Norway;
Kraggerud H; Hamre C; Wouda M

Journal of Rehabilitation Medicine. 58:jrm44817, 2026 Jul 23.

OBJECTIVE: To investigate lung function and ventilatory response during
cardiopulmonary exercise testing in adults with cerebral palsy and assess
the relationship between perceived breathlessness and breathing reserve at
maximal exertion.

DESIGN: Prospective, cross-sectional study. Inclusion period October
2023-June 2024.

SUBJECTS: Adults with spastic cerebral palsy, Gross Motor Function
Classification Score (GMFCS) I-III (n = 100).

METHODS: Spirometry and cardiopulmonary exercise testing were conducted.
Ventilatory response during exercise was assessed via tidal volume and
respiratory rate. Perceived breathlessness was compared with breathing
reserve at maximal exertion.

RESULTS: 89 participants completed all tests (GMFCS I = 62, GMFCS II =
20, GMFCS III = 7); 90% had lung function within normal limits. Age- and
sex-adjusted maximal oxygen uptake was lowest in group III (p < 0.01). At
maximal exertion, 70% had breathing reserve < 20%, indicating ventilatory
limitation. Breathing reserve did not significantly differ between those
who did and did not report breathlessness as the limiting factor at
maximal exertion. Tidal volume and respiratory rate showed expected values
at maximal exertion.

CONCLUSION: Lung function was normal in most participants, yet
ventilatory limitations were common during maximal exercise. Perceived
breathlessness was not related to breathing reserve at maximal exertion.

Normative reference equations for leg discomfort during incremental cardiopulmonary cycle exercise testing in older adults.

Aucoin R; Dalhousie University, Halifax, Nova Scotia, Canada.
Jensen D; Stickland M; Brotto A et al

Clinical Physiology & Functional Imaging. 46(4):e70083, 2026 Jul.

BACKGROUND: Leg discomfort, assessed with the Borg category-ratio 0-10
(Borg CR10) scale, is a primary reason for exercise cessation in both
health and disease. However, interpretation during cardiopulmonary
exercise testing (CPET) is limited by the absence of normative reference
equations.

PURPOSE: Develop normative reference equations for leg discomfort during
CPET in relation to absolute and relative power output (W) and rate of
oxygen uptake (V’O2).

METHODS: This was a retrospective analysis of the Canadian Cohort
Obstructive Lung Disease (CanCOLD) study. We included healthy males and
females aged >=40 years who completed symptom limited incremental cycle
CPET. The probability of each Borg CR10 leg discomfort rating by W or V’O2
was predicted using multinomial logistic regression. Model performance was
evaluated by fit, calibration, discrimination (c-statistic), and
externally validated in an independent sample (n = 86) of healthy Canadian
adults.

RESULTS: In total, 156 participants (43% female) were included (mean age
64.8 years). The models demonstrated good discrimination in both internal
and external validation (AUC 0.85-0.90), with similar performance across
absolute and relative W and V’O2. An upper limit of normal ([ULN]; 95th
percentile) could not be defined, as leg discomfort responses were highly
clustered within the predicted normal range across exercise intensities.

CONCLUSIONS: We present normative reference equations for leg discomfort
during CPET. Although an ULN could not be established, these models enable
grading and interpretation of leg discomfort relative to the predicted
normal responses and facilitate comparisons across individuals and groups
in both clinical and research settings.

Objective Assessment of Functional Capacity Improvement Following Transcatheter Tricuspid Valve Interventions.

Cumitini L; Maggiore della Carita Hospital, Novara, Italy.
Giubertoni A; Mennuni M; Degiovanni A; Patti G

American Journal of Cardiology. 272:54-59, 2026 Aug 01.

Transcatheter tricuspid valve interventions have recently emerged as
effective therapeutic options for patients with severe tricuspid
regurgitation (TR) and heart failure at high surgical risk. Despite
evidence of post-procedural clinical improvement, data regarding changes
in functional capacity remain limited. In this prospective, observational
study, we enrolled high-risk patients with at least severe TR and heart
failure undergoing transcatheter tricuspid valve repair by the PASCAL
device or replacement with the EVOQUE system. Functional capacity was
evaluated by cardiopulmonary exercise testing (CPET), in addition to
clinical, laboratory, and echocardiographic parameters, at baseline and 3
months postprocedure. The primary endpoint was the change in peak oxygen
consumption (VO2) by CPET at 3 months versus baseline. Secondary endpoints
included changes in other CPET parameters, TR severity by transthoracic
echocardiography, New York Heart Association (NYHA) class, daily
furosemide dose, and pro-brain natriuretic peptide (pro-BNP) levels. A
total of 10 patients were enrolled, with successful device implantation
obtained in all cases. Peak VO2 improved significantly from 14.7 +/- 3.7
at baseline to 16.4 +/- 2.9 ml/kg/min at 3 months (p = 0.009). Peak oxygen
pulse increased from 85.1 +/- 20.2% to 103.7 +/- 23.3% (p = 0.022), and
ventilation maximum rose from 39.9 +/- 10.3 L/min to 45.7 +/- 10.9 L/min
(p = 0.035). TR severity was reduced (p = 0.002), NYHA class improved (p =
0.016), and daily furosemide dose decreased (p = 0.016). Although pro-BNP
levels declined, this reduction was not statistically significant. No
adverse event occurred during follow-up. In conclusion, among patients
with severe TR and heart failure, TR reduction by transcatheter tricuspid
valve interventions was associated with improved CPET-derived functional
capacity, better functional class, and reduced diuretic requirement during
short-term follow-up.

Preoperative and intraoperative oxygen consumption in patients undergoing lung resection surgery: a retrospective study using cardiopulmonary exercise test and intraoperative data.

Oh C; Department of Anesthesiology Daejeon, 35015, Korea.
Park S; Lee S; Chong Y;et al

BMC Anesthesiology. 26(1), 2026 May 14.

BACKGROUND: Oxygen consumption (VO2) is a core element of hemodynamic
physiology and the metabolic counterpart to oxygen delivery. Modern
anesthesia machines enable real-time intraoperative VO2 estimation, yet
its relationship with preoperative metabolic capacity, as characterized by
cardiopulmonary exercise testing (CPET), has not been directly examined.

METHODS: This study analyzed preoperative CPET and intraoperative data
from adult patients >= 20 undergoing lung resection under general
anesthesia. Intraoperative VO2 was estimated from minute ventilation and
inspired and end-tidal oxygen fractions. Preoperative and intraoperative
VO2 were summarized, and associations between baseline VO2 and
intraoperative suppression were assessed.

RESULTS: Data from 32 patients were analyzed. Preoperative VO2 at rest,
anaerobic threshold, and peak exercise were 1.6 +/- 0.4, 5.1 +/- 1.9, and
6.1 +/- 1.7 metabolic equivalents (METs), respectively. The reduction from
resting to intraoperative VO2 (-29.0 +/- 19.4%) showed a strong
correlation with resting VO2 (r = 0.770, p < 0.001). Consequently,
regardless of preoperative resting VO2, intraoperative VO2 converged to a
relatively narrow range, averaging 1.1 +/- 0.2 METs.

CONCLUSIONS: In patients undergoing lung resection, intraoperative VO2
converged to approximately 1 MET under general anesthesia, largely
independent of preoperative resting metabolism. The clinical implications
of this observation remain unclear and warrant investigation in larger
prospective studies incorporating concurrent measurements of oxygen
delivery and clinical outcomes.

Prognostic Value of the Hemodynamic Gain Index in Patients With Hypertrophic Cardiomyopathy.

Vanhentenrijk S; Vascular and Thoracic Institute, Cleveland Clinic,
Cleveland, Ohio. USA
Chaikijurajai T; Engelman T; Grodin JL;et al

American Journal of Cardiology. 272:103-109, 2026 Aug 01.

Hemodynamic gain index (HGI) is a novel, simple parameter calculated from
resting and peak systolic blood pressure and heart rate (HR) during
exercise, however, its prognostic value in patients with hypertrophic
cardiomyopathy (HCM) is unknown. We investigate the prognostic value of
alternative nonmetabolic exercise testing parameters in a contemporary HCM
cohort. HGI was calculated from systolic blood pressure at rest and peak
/HR data from consecutive HCM patients who underwent cardiopulmonary
exercise testing for symptom evaluation. Multivariable Cox regression
analysis was performed with the primary outcome of all-cause mortality
and/or heart transplantation. Logistic regression models were used for HGI
to predict the need for future myectomy or alcohol septal ablation. In our
cohort of 905 patients with HCM, HGI correlated well with circulatory
power (CP, r = 0.71, p <0.001) and peak VO2 (r = 0.64, p <0.001). HGI
(Area Under Curve (AUC) 0.87, 95% CI 0.81-0.92) demonstrated comparable
accuracies to CP (AUC 0.88, 95% CI 0.83-0.92) and peak VO2 (AUC 0.81, 95%
CI 0.75-0.87) in predicting transplant-free survival. Higher HGI was
independently associated with a lower risk of primary endpoint (adjusted
HR 0.25, 95% CI 0.15-0.42, p <0.001), all-cause mortality (adjusted HR
0.31,95% CI 0.17-0.56, p <0.001), and was associated with lower risk for
future myectomy or alcohol septal ablation (OR 0.78, 95% CI 0.67-0.91, p =
0.002). HGI may serve as an independent predictor for adverse outcomes in
patients with HCM with comparable prognostic value to peak VO2 and CP. In
addition, HGI may identify those who would likely need myectomy or alcohol
septal ablation, independent of pVO2 evaluation.

Prognostic value of ventilatory efficiency in hypersensitivity pneumonitis.