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    Cardiopulmonary responses to exercise in moderate-to-severe obstructive sleep apnea
    (Turkish Assoc Tuberculosis & Thorax, 2005) Ozturk, Levent; Metin, Gokhan; Cuhadaroglu, Caglar; Utkusavas, Ayfer; Tutluoglu, Bulent
    Information regarding the safety of maximal cardiopulmonary exercise testing (CPET) or the mechanisms of exercise limitation in obstructive sleep apnea (OSA) patients is fairly limited. In the present study, we addressed the problem of exercise capacity in moderate-to-severe OSA patients. Nineteen non-consecutive patients (three female, 16 male) with moderate-to-severe OSA and 11 age and body mass index matched control subjects (four female, seven male) underwent respiratory function tests during pre-exercise resting period and volitionally limited cardiopulmonary exercise testing on an electronically braked cycle ergometer. All participants completed CPET without any complication. Control subjects were exercise limited due to deconditioning. None of the patients revealed mechanical ventilatory limitation to exercise or had evidence of cardiac ischaemia. Five patients had no limitation to exercise. Six patients had low VO2peak, low anaerobic treshold (AT), and low peak O-2 pulse, a pattern consistent with ventricular dysfunction. Six patients had low VO2peak, low AT, and peak heart rate less than 85% predicted. This pattern is consistent with exercise limitation due to peripheral vascular disease. Two patients had low VO2peak, low AT without peak oxygen pulse and peak heart rate abnormalities consistent with deconditioning. We concluded that moderate-to-severe OSA patients have impaired exercise capacity. Exercise limitation seems to originate from cardiovascular reasons namely left ventricular dysfunction and/or peripheral vascular impairment; and finally, maximal CPET can be tolerated by these patient group without serious complications.
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    Effects of Smoking Cessation on Physical Exercise Capacity
    (Aves, 2005) Metin, Gokhan; Yucel, Rofat; Altan, Mehmet; Ozturk, Levent; Tutluoglu, Bulent
    Exercise has been recommended as an adjunct method for smoking cessation. From this point of view, performing exercise tests is becoming increasingly important for determining cardiopulmonary risk factors which individuals carry, for prescribing adequate exercise regimes, and for objectively measuring changes in physical capacity during abstinence period. In this study, we aimed to investigate short term changes in cardiopulmonary exercise capacity of individuals that stop smoking. Thirty-nine (25F/14M) asymptomatic volunteers were recruited from Stop Smoking Clinics, Department of Chest Diseases, Cerrahpasa Faculty of Medicine, Istanbul University. Participants underwent maximal cardiopulmonary exercise testing (CPET) on a cycle ergometer by 20 watt/2 min increases until reaching 85% of age-pre-dicted maximal heart rate. CPET was performed in the 1st and 10th weeks of abstinence period. Gas analyses (VO2 and VCO2) were made using expiration air. Prior to CPET, resting lung function tests were performed for each participant. In the whole group, body weight and body mass index increased (p< 0.01; p< 0.01). Maximal oxygen consumption (VO2max), exercise duration, and work performed by the participants also increased ( p< 0.01; p< 0.001; p< 0.001). In conclusion, smokers well-tolerated cardiopulmonary exercise test without any complications. Aerobic performance parameters of smokers improved significantly in an abstinence period of even as short as 10 weeks.